Individual provider Active NPI

Deidra Rhonyia Pittman, LPC

  • Professional Counselor
  • Oak Brook, IL
National Provider Identifier
1841980414
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.020602 Issued in IL
Practice address
125 Windsor Dr
Oak Brook, IL 60523-1536
Phone
(630) 728-1744
NPI assigned
May 8, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178.020602 IL Primary

Addresses

Primary practice location

125 Windsor Dr
Oak Brook, IL 60523-1536

Mailing address

125 Windsor Dr Ste 113
Oak Brook, IL 60523-4082

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

LicenseStateTypeSpecialty
178.020602ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1841980414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WINDSOR DR STE 113",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605234082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 WINDSOR DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231536",
            "telephone_number": "630-728-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTMAN",
        "first_name": "DEIDRA",
        "middle_name": "RHONYIA",
        "name_prefix": "Prof.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.020602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

  • 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.