Individual provider Active NPI

Laura E. Deyoung, LCPC

  • Professional Counselor
  • Bourbonnais, IL
National Provider Identifier
1659569630
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.006499 Issued in IL
Practice address
750 Almar Pkwy
Bourbonnais, IL 60914-2315
Phone
(815) 768-6545
NPI assigned
Oct 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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 180.006499 IL Primary

Addresses

Primary practice location

750 Almar Pkwy
Bourbonnais, IL 60914-2315

Mailing address

914 Percy Dr
Bourbonnais, IL 60914-1895
Phone (815) 929-0716

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
180.006499ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191456000000",
    "number": "1659569630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 PERCY DR",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141895",
            "telephone_number": "815-929-0716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 ALMAR PKWY",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142315",
            "telephone_number": "815-768-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEYOUNG",
        "first_name": "LAURA",
        "middle_name": "E.",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-04",
        "last_updated": "2007-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.006499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.

Verify at the official NPI Registry.