Active NPI
Marla Dexter, LPC
- Professional Counselor
- Dekalb, IL
National Provider Identifier
1669720272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 178007932
- Practice address
- 12 Health Services Dr
Dekalb, IL 60115-9637 - Phone
- (815) 756-4875
- Fax
- (815) 756-2944
- NPI assigned
- Aug 29, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178007932 | IL | Primary |
Addresses
Primary practice location
12 Health Services Dr
Dekalb, IL 60115-9637
Mailing address
12 Health Services Dr
Dekalb, IL 60115-9637
Phone (815) 756-4875
Other names 1
- Miss Marla Wieting
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
| License | State | Type | Specialty |
|---|---|---|---|
| 178007932 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346198400000",
"number": "1669720272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 HEALTH SERVICES DR",
"city": "DEKALB",
"state": "IL",
"postal_code": "601159637",
"telephone_number": "815-756-4875",
"fax_number": "815-756-2944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 HEALTH SERVICES DR",
"city": "DEKALB",
"state": "IL",
"postal_code": "601159637",
"telephone_number": "815-756-4875",
"fax_number": "815-756-2944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEXTER",
"first_name": "MARLA",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-29",
"last_updated": "2012-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178007932",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARLA",
"last_name": "WIETING",
"prefix": "MISS",
"credential": "LPC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Dekalb, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.