Revita Dechalus, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178006723 Issued in IL

Practice address

3436 N Kennicott Ave
Arlington Heights, IL 60004-7814

Phone

(947) 952-7460

Fax

(847) 222-1754

NPI assigned

Nov 10, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: revita.dechalus.1@21300.direct.athenahealth.com

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

{
    "created_epoch": "1478736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478736000000",
    "number": "1982146718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3436 N KENNICOTT AVE",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600047814",
            "telephone_number": "947-952-7460",
            "fax_number": "847-222-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3436 N KENNICOTT AVE",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600047814",
            "telephone_number": "947-952-7460",
            "fax_number": "847-222-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECHALUS",
        "first_name": "REVITA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-10",
        "last_updated": "2016-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178006723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Michael Delaney

• Professional Counselor in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; 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.