Individual provider Active NPI

Emily Peters, LPC

  • Professional Counselor
  • Lake Villa, IL
National Provider Identifier
1275018491
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178013112 Issued in IL
Practice address
25480 W Cedar Crest LN
Lake Villa, IL 60046-9744
Phone
(847) 356-8205
NPI assigned
Oct 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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 178013112 IL Primary

Addresses

Primary practice location

25480 W Cedar Crest LN
Lake Villa, IL 60046-9744

Mailing address

25480 W Cedar Crest LN
Lake Villa, IL 60046-8256
Phone (847) 356-8205

Other identifiers 1

IdentifierTypeStateIssuer
178013112OtherILILLINOIS STATE PROFESSIONAL LICENSE

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
178013112ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1275018491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25480 W CEDAR CREST LN",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600468256",
            "telephone_number": "847-356-8205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25480 W CEDAR CREST LN",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600469744",
            "telephone_number": "847-356-8205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "EMILY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178013112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS STATE PROFESSIONAL LICENSE",
            "identifier": "178013112",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Villa, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2019; 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.