Active NPI
Mira Dahlheim, LSW
- Mental Health Counselor
- Geneva, IL
National Provider Identifier
1750621736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 150014127
- Practice address
- 1120 Randall CT
Geneva, IL 60134-3911 - Phone
- (630) 232-1070
- Fax
- (630) 232-1471
- NPI assigned
- Feb 27, 2013
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 150014127 | IL | Primary |
Addresses
Primary practice location
1120 Randall CT
Geneva, IL 60134-3911
Mailing address
1120 Randall CT
Geneva, IL 60134-3911
Phone (630) 232-1070
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 451519 | Medicaid | IL |
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 |
|---|---|---|---|
| 150014127 | IL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361923200000",
"number": "1750621736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 RANDALL CT",
"city": "GENEVA",
"state": "IL",
"postal_code": "601343911",
"telephone_number": "630-232-1070",
"fax_number": "630-232-1471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 RANDALL CT",
"city": "GENEVA",
"state": "IL",
"postal_code": "601343911",
"telephone_number": "630-232-1070",
"fax_number": "630-232-1471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAHLHEIM",
"first_name": "MIRA",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-27",
"last_updated": "2013-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "150014127",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "451519",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Geneva, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.