Individual provider Active NPI

Deborah A. Gust, M.A.

  • Professional Counselor
  • Gurnee, IL
National Provider Identifier
1962480111
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
4343 Old Grand Avenue
Suite 107C
Gurnee, IL 60031-3393
Phone
(847) 662-2174
Fax
(847) 662-2159
NPI assigned
Jan 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

4343 Old Grand Avenue
Suite 107C
Gurnee, IL 60031-3393

Mailing address

4343 Old Grand Avenue
Ste. 107C
Gurnee, IL 60031-3393
Phone (847) 662-2174

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
180-003377ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Co-Operative Partners in Therapy Professional Past 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": "1136592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962480111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 OLD GRAND AVENUE",
            "address_2": "STE. 107C",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313393",
            "telephone_number": "847-662-2174",
            "fax_number": "847-662-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 OLD GRAND AVENUE",
            "address_2": "SUITE 107C",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313393",
            "telephone_number": "847-662-2174",
            "fax_number": "847-662-2159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUST",
        "first_name": "DEBORAH",
        "middle_name": "A.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.