Active NPI
Kenneth Dunn Jr.
- Professional Counselor
- Springfield, IL
National Provider Identifier
1881091841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 178.010427
- Practice address
- 901 N 1St St Ste 225
Springfield, IL 62702-3760 - Phone
- (217) 788-4065
- Fax
- (217) 788-4147
- NPI assigned
- Nov 19, 2014
- Last updated
- Dec 18, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178.010427 | IL | Primary |
Addresses
Primary practice location
901 N 1St St Ste 225
Springfield, IL 62702-3760
Mailing address
901 N 1St St Ste 225
Springfield, IL 62702-3760
Phone (217) 788-4065
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180010525 | Other | IL | LCPC LISCENSE NUMBER |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.010427 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702857600000",
"number": "1881091841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 N 1ST ST STE 225",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627023760",
"telephone_number": "217-788-4065",
"fax_number": "217-788-4147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 N 1ST ST STE 225",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627023760",
"telephone_number": "217-788-4065",
"fax_number": "217-788-4147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNN",
"first_name": "KENNETH",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-19",
"last_updated": "2023-12-18",
"certification_date": "2023-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178.010427",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCPC LISCENSE NUMBER",
"identifier": "180010525",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.