Active NPI
Laura S Irvin, LCPC
- Professional Counselor
- Geneva, IL
National Provider Identifier
1235464025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180.003945
- Practice address
- 702 Redwing Dr
Geneva, IL 60134-3142 - Phone
- (630) 303-3144
- NPI assigned
- Oct 12, 2009
- Last updated
- Oct 12, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | 180.003945 | IL | Primary |
Addresses
Primary practice location
702 Redwing Dr
Geneva, IL 60134-3142
Mailing address
702 Redwing Dr
Geneva, IL 60134-3142
Phone (630) 303-3144
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180.003945 | Other | IL | ST OF IL DEPT OF FINANCIAL AND PROFESSIONAL REGULATION - DIV OF PROFESSIONAL REG |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 180.003945 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255305600000",
"number": "1235464025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "702 REDWING DR",
"city": "GENEVA",
"state": "IL",
"postal_code": "601343142",
"telephone_number": "630-303-3144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "702 REDWING DR",
"city": "GENEVA",
"state": "IL",
"postal_code": "601343142",
"telephone_number": "630-303-3144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRVIN",
"first_name": "LAURA",
"middle_name": "S",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-12",
"last_updated": "2009-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180.003945",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ST OF IL DEPT OF FINANCIAL AND PROFESSIONAL REGULATION - DIV OF PROFESSIONAL REG",
"identifier": "180.003945",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
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- Sidney U Jain, M.D
- Stephan Roy Jakubowski, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.