Bonnie Durbin

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

2561 Delmar Ave
Granite City, IL 62040-3429

Phone

(618) 999-1668

NPI assigned

Jan 21, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 9

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

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    "created_epoch": "1642723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1447902309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2243 EDISON AVE",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2561 DELMAR AVE",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620403429",
            "telephone_number": "618-999-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURBIN",
        "first_name": "BONNIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-21",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251E1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Ergonomics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "242T00000X",
            "taxonomy_group": "",
            "desc": "Perfusionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246QB0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Pathology, Blood Banking",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246QC2700X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Cytotechnology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246Y00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Health Information",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iqe@mail.com",
            "affiliation": "N",
            "endpointDescription": "linx m ail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2561 Edison Ave",
            "city": "Granite City",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620404818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Professional Counselor in Granite City, IL
• Providers in Granite City, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.