Individual provider Active NPI

Jessica Lynn Dubuar, LCPC

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1528423936
Registry record updated Dec 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180009126 Issued in IL
Practice address
1822 W Byron St Apt 2C
Chicago, IL 60613-2749
Phone
(773) 398-2915
NPI assigned
Dec 30, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180009126 IL Primary

Addresses

Primary practice location

1822 W Byron St Apt 2C
Chicago, IL 60613-2749

Mailing address

1822 W Byron St Apt 2C
Chicago, IL 60613-2749
Phone (773) 398-2915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260615001448 IL Practitioner - Mental Health Counselor 5890267447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

932 W Washington Blvd
Chicago, IL 60607-2217

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180009126ILMDProfessional Counselor

Interoperability endpoints

  • Direct secure messaging: jessica.dubuar.p1@direct.hcenter.nextgenshare.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1528423936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1822 W BYRON ST APT 2C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132749",
            "telephone_number": "773-398-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1822 W BYRON ST APT 2C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132749",
            "telephone_number": "773-398-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBUAR",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-30",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180009126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.