Active NPI
Shobana U Shanmugavelayutham
- Mental Health Counselor
- Naperville, IL
National Provider Identifier
1679134332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 180.012070
- Practice address
- 600 E Diehl Rd Ste 110
Naperville, IL 60563-4896 - Phone
- (630) 428-7890
- NPI assigned
- Jun 24, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 180.012070 | IL | Primary |
Addresses
Primary practice location
600 E Diehl Rd Ste 110
Naperville, IL 60563-4896
Mailing address
2301 Beau Monde Ter Apt 106
Lisle, IL 60532-1528
Phone (331) 551-2447
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180.012070 | IL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561334400000",
"number": "1679134332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 BEAU MONDE TER APT 106",
"city": "LISLE",
"state": "IL",
"postal_code": "605321528",
"telephone_number": "331-551-2447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 E DIEHL RD STE 110",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605634896",
"telephone_number": "630-428-7890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANMUGAVELAYUTHAM",
"first_name": "SHOBANA",
"middle_name": "U",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-24",
"last_updated": "2019-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "180.012070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.