Active NPI
Erik Sean Youngstedt, LCPC
- Professional Counselor
- Glen Ellyn, IL
National Provider Identifier
1619172244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180-004037
- Practice address
- 346 Taft Ave Ste 030
Glen Ellyn, IL 60137-6296 - Phone
- (630) 690-3170
- NPI assigned
- Jun 14, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180-004037 | IL | Primary |
Addresses
Primary practice location
346 Taft Ave Ste 030
Glen Ellyn, IL 60137-6296
Mailing address
462 Illini Dr
Carol Stream, IL 60188-1554
Phone (630) 681-8661
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180-004037 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Marriage Clinic | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Social Worker
- Glen Ellyn, IL
- NPI 1609926005
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619172244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "462 ILLINI DR",
"city": "CAROL STREAM",
"state": "IL",
"postal_code": "601881554",
"telephone_number": "630-681-8661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "346 TAFT AVE STE 030",
"city": "GLEN ELLYN",
"state": "IL",
"postal_code": "601376296",
"telephone_number": "630-690-3170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNGSTEDT",
"first_name": "ERIK",
"middle_name": "SEAN",
"name_prefix": "Mr.",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180-004037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Ellyn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.