Individual provider Active NPI

Biana Mavasheva, LCPC

  • Professional Counselor
  • Highland Park, IL
National Provider Identifier
1972050813
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.013814 Issued in IL
Practice address
994 Coventry LN
Highland Park, IL 60035-3748
Phone
(847) 924-1440
NPI assigned
Sep 8, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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 178.011617 IL
Professional Counselor 101YP2500X 180.013814 IL Primary

Addresses

Primary practice location

994 Coventry LN
Highland Park, IL 60035-3748

Mailing address

994 Coventry LN
Highland Park, IL 60035-3748
Phone (847) 924-1440

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
178.011617ILMDProfessional Counselor
180.013814ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1972050813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "994 COVENTRY LN",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353748",
            "telephone_number": "847-924-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "994 COVENTRY LN",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353748",
            "telephone_number": "847-924-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVASHEVA",
        "first_name": "BIANA",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.011617",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.013814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.