James William Donald Jr., LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180-000792 Issued in IL

Practice address

5101 Washington St
Suite 11 Room 1115
Gurnee, IL 60031-5916

Phone

(847) 313-9659

Fax

(847) 557-1418

NPI assigned

Sep 6, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367798400000",
    "number": "1437408309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 WASHINGTON ST",
            "address_2": "SUITE 11 ROOM 1115",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315916",
            "telephone_number": "847-313-9659",
            "fax_number": "847-557-1418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 WASHINGTON ST",
            "address_2": "SUITE 11 ROOM 1115",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315916",
            "telephone_number": "847-313-9659",
            "fax_number": "847-557-1418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONALD",
        "first_name": "JAMES",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-06",
        "last_updated": "2013-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-000792",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "1815",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12482712",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Gurnee, IL
• Providers in Gurnee, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2013; 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.