Eric Eblin, MSW QMHP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

406 E Vine St
Vienna, IL 62995-1612

Phone

(618) 658-3079

Fax

(618) 658-2759

NPI assigned

Sep 27, 2019

Last updated

Sep 27, 2019By the provider in NPPES

Sex

Male

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Arrowleaf

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Vienna, IL
  • NPI 1114387701
  NPD (past)
• Arrowleaf

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Vienna, IL
  • NPI 1528215290
  NPD (past)

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1982255220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 E VINE ST",
            "city": "VIENNA",
            "state": "IL",
            "postal_code": "629951612",
            "telephone_number": "618-658-3079",
            "fax_number": "618-658-2759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 E VINE ST",
            "city": "VIENNA",
            "state": "IL",
            "postal_code": "629951612",
            "telephone_number": "618-658-3079",
            "fax_number": "618-658-2759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBLIN",
        "first_name": "ERIC",
        "credential": "MSW QMHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-27",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Connie Larae Duncan, LCSW
• Olivia Durapau, BA, MHP
• Jordan Eberhart, BA, MHP
• Kimberly Dawn Ecker, PT
• Rachel Ann Edmonds, PT
• Amanda Endrizzi, MSPA
• Molly Kathleen English, MHP
• Carol Sue Fairless, RN

• Mental Health Counselor in Vienna, IL
• Providers in Vienna, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; 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.