NPIMap

Individual provider Active NPI

David Lee Forbes, LCPC

  • Professional Counselor
  • Springfield, IL
National Provider Identifier
1235474180
Registry record updated Dec 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.005824 Issued in IL
Practice address
701 S Durkin Dr
Suite B
Springfield, IL 62704-6029
Phone
(217) 726-7575
Fax
(217) 726-7577
NPI assigned
Dec 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180.005824 IL Primary

Addresses

Primary practice location

701 S Durkin Dr
Suite B
Springfield, IL 62704-6029

Mailing address

701 S Durkin Dr
Suite B
Springfield, IL 62704-6029
Phone (217) 726-7575

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
180.005824ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Stillwater Center for Wellness PC Past Accepting new patients
Clinical Counseling Group & Dui Providers, LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1354579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354579200000",
    "number": "1235474180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S DURKIN DR",
            "address_2": "SUITE B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046029",
            "telephone_number": "217-726-7575",
            "fax_number": "217-726-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S DURKIN DR",
            "address_2": "SUITE B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046029",
            "telephone_number": "217-726-7575",
            "fax_number": "217-726-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORBES",
        "first_name": "DAVID",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-04",
        "last_updated": "2012-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.005824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; 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.