Active NPI
Jordan Dery, MA, LPC
- Professional Counselor
- West Dundee, IL
National Provider Identifier
1174410765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 178021910
- Practice address
- 528 Market Loop
West Dundee, IL 60118-2193 - Phone
- (636) 706-1746
- NPI assigned
- Jun 18, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178021910 | IL | Primary |
Addresses
Primary practice location
528 Market Loop
West Dundee, IL 60118-2193
Mailing address
528 Market Loop
West Dundee, IL 60118-2193
Phone (636) 706-1746
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178021910 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754352000000",
"number": "1174410765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "528 MARKET LOOP",
"city": "WEST DUNDEE",
"state": "IL",
"postal_code": "601182193",
"telephone_number": "636-706-1746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "528 MARKET LOOP",
"city": "WEST DUNDEE",
"state": "IL",
"postal_code": "601182193",
"telephone_number": "636-706-1746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERY",
"first_name": "JORDAN",
"credential": "MA, LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-06-18",
"last_updated": "2025-08-05",
"certification_date": "2025-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178021910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Dundee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.