Emily Rachel Segal, ATR, LCPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

180.011549 Issued in IL

Practice address

500 Brown Blvd
Bourbonnais, IL 60914-2328

Phone

(815) 214-9766

NPI assigned

May 4, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Emily Rachel Segal Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Collective Balance Counseling, LLC

  • Mental Health Counselor
  • Bourbonnais, IL
  • NPI 1265998058
  NPD

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

{
    "created_epoch": "1588550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588550400000",
    "number": "1467073163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2037 W MORSE AVE APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606454984",
            "telephone_number": "847-404-5747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 BROWN BLVD",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142328",
            "telephone_number": "815-214-9766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGAL",
        "first_name": "EMILY",
        "middle_name": "RACHEL",
        "credential": "ATR, LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-04",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "IL",
            "license": "17-244",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180.011549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "SEGAL",
            "middle_name": "RACHEL",
            "credential": "ATR, LCPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Counselor in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2020; 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.