Sue Blomberg, LCPC, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180008011 Issued in IL

Legal business name

SUE BLOMBERG, LCPC, LLC

Practice address

1040 Chestnut Ave
Wilmette, IL 60091-1732

Phone

(847) 778-9001

NPI assigned

Mar 14, 2013

Organization subpart

No

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

Authorized official

Name

Sue Blomberg, LCPC

Title

Owner

Phone

(847) 778-9001

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1363219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363219200000",
    "number": "1669713772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4765 N LINCOLN AVE",
            "address_2": "SUITE 209",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252077",
            "telephone_number": "847-778-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 CHESTNUT AVE",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911732",
            "telephone_number": "847-778-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUE BLOMBERG, LCPC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-14",
        "last_updated": "2013-03-14",
        "status": "A",
        "authorized_official_last_name": "BLOMBERG",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-778-9001",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180008011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Wilmette, IL
• Providers in Wilmette, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; 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.