Dana Lynn Baker, LCPC
Individual provider Active NPI Professional Counselor · Champaign, IL
NPI 1508300740 · NPPES record last updated Sep 24, 2021
Key facts
- NPI
- 1508300740
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 180.012875 (IL)
- Practice address
- 3015 Village Office PL # B
Champaign, IL 61822-7674 - Phone
- (217) 239-6085
- Fax
- (217) 356-7964
- NPI assigned
- Dec 7, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240123000503 | IL | Practitioner - Mental Health Counselor | 3476905720 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.012562 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Champaign Counseling LLC | Current |
Accepting new patients |
Locations
313 N Mattis Ave
Ste 116
Champaign, IL 61821
Phone (217) 203-2008
7 Dunlap Ct
Savoy, IL 61874
Phone (217) 203-2008
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178.012562 | IL | |
| Professional Counselor | 101YP2500X | 180.012875 | IL | Yes |
Addresses
Primary practice location
3015 Village Office PL # B
Champaign, IL 61822-7674
Mailing address
2501 Southwood Dr
Champaign, IL 61821-5720
Phone (847) 915-8654
Other names
- Dana Lynn Miller
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://app.therabill.com/provider | Direct |
Other providers in Champaign, IL
- Stephanie(Tess) A Bailey
- Hannah Baines
- Jasmine Baines
- Maria Lennie Baisa
- Brady Baker
- John P Baker
- Linda Susan Baker
- Balgemann Optometry Group, Inc.
- Michael Garrett Balgemann
- Randy Allan Ballard
All providers in Champaign, IL · Professional Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.