Individual provider Active NPI

Karissa Samara Tobey, MA, LCPC

  • Mental Health Counselor
  • St Charles, IL
National Provider Identifier
1336652460
Registry record updated Apr 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.014784 Issued in IL
Practice address
2035 Foxfield Rd Ste 202
Saint Charles, IL 60174-5750
Phone
(630) 425-2025
NPI assigned
Nov 11, 2017
Last updated
Apr 28, 2024By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180.014784 IL Primary
Professional Counselor 101YP2500X 178.013451 IL

Addresses

Primary practice location

2035 Foxfield Rd Ste 202
Saint Charles, IL 60174-5750

Mailing address

2035 Foxfield Rd Ste 202
St Charles, IL 60174-5750
Phone (630) 425-2025

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

LicenseStateTypeSpecialty
180.014784ILMDMental Health Counselor
178.013451ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Prism Point Counseling LTD Mental Health CurrentSince Apr 9, 2024 Accepting new patients

Locations

2035 Foxfield Rd
Ste 202
St Charles, IL 60174
Phone (630) 425-2025

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1510358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714262400000",
    "number": "1336652460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 FOXFIELD RD STE 202",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601745750",
            "telephone_number": "630-425-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 FOXFIELD RD STE 202",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601745750",
            "telephone_number": "630-425-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBEY",
        "first_name": "KARISSA",
        "middle_name": "SAMARA",
        "credential": "MA, LCPC",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2017-11-11",
        "last_updated": "2024-04-28",
        "certification_date": "2024-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.014784",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.013451",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2024; 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.