Nina Monet Dismukes

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

178017543 Issued in IL

Practice address

1 E Erie St
Chicago, IL 60611-2740

Phone

(630) 428-7891

Fax

(630) 428-7891

NPI assigned

Mar 31, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: nina.dismukes@lifestance.com

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.

• Rebalance Therapy Mind. Body. Soul.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milwaukee, WI
  • NPI 1770360968
  NPD Authorized official
• Edgewood Clinical Services, P.C.

  • Psychologist
  • Naperville, IL
  • NPI 1295914646

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1821676818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3867 N 79TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532222913",
            "telephone_number": "414-446-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E ERIE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112740",
            "telephone_number": "630-428-7891",
            "fax_number": "630-428-7891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISMUKES",
        "first_name": "NINA",
        "middle_name": "MONET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-31",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178017543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Nina.dismukes@lifestance.com",
            "affiliation": "N",
            "address_1": "1 E Erie St Ste 520",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606112792",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Nina.dismukes@lifestance.com",
            "affiliation": "N",
            "address_1": "1 E Erie St Ste 520",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606112792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carol Dishell
• Tajai Dishmon
• Jeanne E Disis, DPT
• Ariana Raquel Dismer, CF-CCC
• Brandon Toure' Dismukes
• Marco Antonio Dispagna, MD
• Dispatchhealth-Arizona
• Karl F Disque, D.O. RPH
• Vinodinee Lanka Dissanayake, M.D.
• John Louis Disselhorst

• Mental Health Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.