Active NPI
Debra Benjamin Goldman, MA,BC-DMT,LCPC
- Professional Counselor
- Highland Park, IL
National Provider Identifier
1699100792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180.002612
- Practice address
- 1802 Elmwood Dr
Highland Park, IL 60035-2303 - Phone
- (847) 831-5974
- NPI assigned
- Sep 8, 2013
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180.002612 | IL | Primary |
Addresses
Primary practice location
1802 Elmwood Dr
Highland Park, IL 60035-2303
Mailing address
1802 Elmwood Dr
Highland Park, IL 60035-2303
Phone (847) 831-5974
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180.002612 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378598400000",
"number": "1699100792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1802 ELMWOOD DR",
"city": "HIGHLAND PARK",
"state": "IL",
"postal_code": "600352303",
"telephone_number": "847-831-5974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1802 ELMWOOD DR",
"city": "HIGHLAND PARK",
"state": "IL",
"postal_code": "600352303",
"telephone_number": "847-831-5974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDMAN",
"first_name": "DEBRA",
"middle_name": "BENJAMIN",
"credential": "MA,BC-DMT,LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-08",
"last_updated": "2013-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180.002612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Highland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.