Individual provider Active NPI

Alicja Dziobacka, LPC

  • Mental Health Counselor
  • Lake in the Hills, IL
National Provider Identifier
1174106058
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178016723 Issued in IL
Practice address
9241 S Il Route 31
Lake in the Hills, IL 60156-1607
Phone
(847) 854-4333
NPI assigned
Apr 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178016723 IL Primary

Addresses

Primary practice location

9241 S Il Route 31
Lake in the Hills, IL 60156-1607

Mailing address

9241 S Il Route 31
Lake in the Hills, IL 60156-1607
Phone (847) 854-4333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
178016723ILMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1174106058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9241 S IL ROUTE 31",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601561607",
            "telephone_number": "847-854-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9241 S IL ROUTE 31",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601561607",
            "telephone_number": "847-854-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIOBACKA",
        "first_name": "ALICJA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178016723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake in the Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.