Emily Jeanne Deaver, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.011964 Issued in IL

Practice address

1954 W Irving Park Rd
Chicago, IL 60613-2408

Phone

(773) 217-9371

NPI assigned

Dec 25, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Embolden Therapy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1003778317
  NPD Authorized official
• Psychotherapy Associates of Chicago

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1568518520
  NPD (past)

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

{
    "created_epoch": "1545696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1770055105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 W 15TH PL UNIT 503",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081641",
            "telephone_number": "630-988-3226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1954 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132408",
            "telephone_number": "773-217-9371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAVER",
        "first_name": "EMILY",
        "middle_name": "JEANNE",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-25",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180011964",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.011964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tessa Dearth
• Joseph Anthony Deasa, LCPC
• Katherine Lenore Deasy, OTR/L
• Mary Fe Deaton, NP
• Michael Deavens
• Robert S Deaver, DDS
• Elizabeth Deavilla, RDN, LDN
• Noel Albert Debacker, M.D.
• Abbey Michelle Debaene, LCSW, CADC
• Casie Lynn Debardi, OTR/L

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.