Eleanor Angeline Schupick, M.A., CADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

080309. Issued in IA

Practice address

400 S Broadway St
Burlington, IA 52601-9407

Phone

(319) 752-4000

NPI assigned

Aug 19, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461715200000",
    "number": "1619257722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SOUTH BROADWAY",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526019407",
            "telephone_number": "319-752-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S BROADWAY ST",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526019407",
            "telephone_number": "319-752-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUPICK",
        "first_name": "ELEANOR",
        "middle_name": "ANGELINE",
        "name_prefix": "Mrs.",
        "credential": "M.A., CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2016-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IA",
            "license": "94134",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "080309.",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED ALCOHOL AND DRUG COUNSELOR",
            "identifier": "94134",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Burlington, IA
• Providers in Burlington, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.