Individual provider Active NPI

Margaret Davis Tebo, LPC, LCPC

  • Counselor
  • Chicago, IL
National Provider Identifier
1922690510
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
178.015667 Issued in IL
Practice address
155 N Michigan Ave Ste 202&723
Chicago, IL 60601-7511
Phone
(312) 278-3054
NPI assigned
Feb 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC014109 GA
Counselor 101Y00000X 178.015667 IL Primary

Addresses

Primary practice location

155 N Michigan Ave Ste 202&723
Chicago, IL 60601-7511

Mailing address

4201 Ridgehurst Dr SE
Smyrna, GA 30080-3114
Phone (678) 777-4579

Other practice location 1

4201 Ridgehurst Dr SE
Smyrna, GA 30080-3114
Phone (678) 777-4579

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
178.015667ILMDCounselor
LPC014109GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Balance Professional CurrentSince Sep 29, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1922690510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 RIDGEHURST DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300803114",
            "telephone_number": "678-777-4579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N MICHIGAN AVE STE 202&723",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017511",
            "telephone_number": "312-278-3054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 Ridgehurst Dr SE",
            "address_purpose": "LOCATION",
            "city": "Smyrna",
            "state": "GA",
            "postal_code": "300803114",
            "country_code": "US",
            "telephone_number": "678-777-4579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEBO",
        "first_name": "MARGARET",
        "middle_name": "DAVIS",
        "credential": "LPC, LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-05",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC014109",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178.015667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.