Individual provider Active NPI

Dana King, LCPC

  • Counselor
  • Evanston, IL
National Provider Identifier
1639647878
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
180.011765 Issued in IL
Practice address
1830 Sherman Ave Ste 404
Evanston, IL 60201-3774
Phone
(312) 636-9571
NPI assigned
Nov 6, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 180.011765 IL Primary

Addresses

Primary practice location

1830 Sherman Ave Ste 404
Evanston, IL 60201-3774

Mailing address

7737 N Eastlake Ter Apt 3M
Chicago, IL 60626-1333
Phone (312) 636-9571

Other practice location 1

1096 W Pratt Blvd Apt 2S
Chicago, IL 60626-4480
Phone (312) 636-9571

Other practice location 2

5250 Old Orchard Rd Ste 300
Skokie, IL 60077-4462
Phone (312) 636-9571

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

LicenseStateTypeSpecialty
180.011765ILMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1639647878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7737 N EASTLAKE TER APT 3M",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606261333",
            "telephone_number": "312-636-9571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 SHERMAN AVE STE 404",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013774",
            "telephone_number": "312-636-9571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1096 W Pratt Blvd Apt 2S",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606264480",
            "country_code": "US",
            "telephone_number": "312-636-9571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5250 Old Orchard Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600774462",
            "country_code": "US",
            "telephone_number": "312-636-9571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "DANA",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-06",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180.011765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; 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.