Individual provider Active NPI

Erin Dubba, LCPC, ATR, MS, MA

  • Professional Counselor
  • St Charles, IL
National Provider Identifier
1659786325
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.008882 Issued in IL
Practice address
405 Illinois Ave Unit 2C
St Charles, IL 60174-2963
Phone
(630) 530-5007
NPI assigned
Jun 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180.008882 IL
Professional Counselor 101YP2500X 180.008882 IL Primary

Addresses

Primary practice location

405 Illinois Ave Unit 2C
St Charles, IL 60174-2963

Mailing address

200 Elgin Ave Apt 1
Forest Park, IL 60130-1398
Phone (312) 508-3281

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
Credentials
Master of Arts, Master of Science

State licenses

LicenseStateTypeSpecialty
180.008882ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
David Goodman, PH.D. Psychologist LTD. 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1659786325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ELGIN AVE APT 1",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601301398",
            "telephone_number": "312-508-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 ILLINOIS AVE UNIT 2C",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742963",
            "telephone_number": "630-530-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBBA",
        "first_name": "ERIN",
        "credential": "LCPC, ATR, MS, MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-21",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.008882",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.008882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; 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.