Deanna R Blyth, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

178015369 Issued in IL

Practice address

3513 Cricket Ave
New Lenox, IL 60451-9785

Phone

(815) 351-0208

NPI assigned

Nov 15, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Juniper Center PCGroup PAC ID 1557557725, 26 clinicians

Great Changes Counseling Services, P.C.Group PAC ID 3375718604, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Great Changes Counseling Services, P.C.

  • Clinical Social Worker
  • Mokena, IL
  • NPI 1205137346
  Medicare reassignment Care Compare group NPD
• The Juniper Center PC

  • Mental Health Counselor
  • Park Ridge, IL
  • NPI 1902906324
  Medicare reassignment Care Compare group
• Therapy Studio

  • Mental Health Counselor
  • Coal City, IL
  • NPI 1518502251
  NPD (past)

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

{
    "created_epoch": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1295370930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3513 CRICKET AVE",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519785",
            "telephone_number": "815-351-0208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3513 CRICKET AVE",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519785",
            "telephone_number": "815-351-0208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLYTH",
        "first_name": "DEANNA",
        "middle_name": "R",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-15",
        "last_updated": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178015369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS",
            "identifier": "178015369",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dblyth@jjc.edu",
            "affiliation": "N",
            "endpointDescription": "dblyth@jjc.edu",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3513 Cricket Ave",
            "city": "New Lenox",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604519785",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "dblyth@jjc.edu",
            "affiliation": "Y",
            "endpointDescription": "college",
            "affiliationName": "Guardian Angel Community Services",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3513 Cricket Ave",
            "city": "New Lenox",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604519785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kevin Christopher Bigart, M.D.
• Lauren Margaret Biggs
• Jennifer Blaszczyk
• David Blatzheim Hickey
• Ashley Blocker
• Bmi Surgery SC
• Christine Anne Bodzianowski
• Syed Saqib Abrar Bokhari, M.D.
• Melissa Kay Bollinger, O.D.
• Erik Borncamp, MD

• Mental Health Counselor in New Lenox, IL
• Providers in New Lenox, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.