Individual provider Active NPI

Deanna Roberts, LCPC, BC-DMT

  • Professional Counselor
  • Evanston, IL
National Provider Identifier
1982016986
Registry record updated Jan 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.009453 Issued in IL
Practice address
1007 Church St
Suite 302
Evanston, IL 60201-3624
Phone
(847) 448-8341
NPI assigned
May 24, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2015

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 180.009453 IL Primary
Dance Therapist 225600000X 1175 IL

Addresses

Primary practice location

1007 Church St
Suite 302
Evanston, IL 60201-3624

Mailing address

1007 Church St
Suite 302
Evanston, IL 60201-3624
Phone (773) 571-7375

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
180.009453ILMDProfessional Counselor
1175ILMDDance Therapist

NPI Registry JSON

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

{
    "created_epoch": "1400889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420588800000",
    "number": "1982016986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 CHURCH ST",
            "address_2": "SUITE 302",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013624",
            "telephone_number": "773-571-7375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 CHURCH ST",
            "address_2": "SUITE 302",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013624",
            "telephone_number": "847-448-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "DEANNA",
        "credential": "LCPC, BC-DMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-24",
        "last_updated": "2015-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.009453",
            "primary": true
        },
        {
            "code": "225600000X",
            "taxonomy_group": "",
            "desc": "Dance Therapist",
            "state": "IL",
            "license": "1175",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; 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.