Individual provider Active NPI

Dana Cibulka, MA

  • Mental Health Counselor
  • Forest Park, IL
National Provider Identifier
1477916286
Registry record updated Mar 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
8311 Roosevelt Rd
Forest Park, IL 60130-2529
Phone
(708) 771-7000
Fax
(708) 488-4951
NPI assigned
Mar 30, 2016
Sex
Female
Sole proprietor
Yes

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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

NPPES NPI Registry

Primary practice location

8311 Roosevelt Rd
Forest Park, IL 60130-2529

Mailing address

8311 Roosevelt Rd
Forest Park, IL 60130-2529
Phone (708) 771-7000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 30, 2016.

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459296000000",
    "number": "1477916286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8311 ROOSEVELT RD",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302529",
            "telephone_number": "708-771-7000",
            "fax_number": "708-488-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8311 ROOSEVELT RD",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302529",
            "telephone_number": "708-771-7000",
            "fax_number": "708-488-4951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIBULKA",
        "first_name": "DANA",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-30",
        "last_updated": "2016-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; 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.