Individual provider Active NPI

Deborah Marie Brisebois, LCSW, LMHP, MSW

  • Clinical Social Worker
  • Elgin, IL
National Provider Identifier
1992076061
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.016361 Issued in IL
Practice address
2295 Valley Creek Dr Ste I
Elgin, IL 60123-2694
Phone
(847) 687-4361
NPI assigned
Jan 22, 2012
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Health & Wellness Coach 171400000X
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X 149.016361 IL Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X

Addresses

Primary practice location

2295 Valley Creek Dr Ste I
Elgin, IL 60123-2694

Mailing address

936 Appaloosa CT
Sleepy Hollow, IL 60118-2517
Phone (847) 687-4361

Other practice location 1

1845 Grandstand Pl
Elgin, IL 60123-6603
Phone (847) 695-0484

Other practice location 2

75 Market St Ste 12
Elgin, IL 60123-5061
Phone (847) 697-6290

Other practice location 3

77 Airlite St
Behavioral Health Unit
Elgin, IL 60123
Phone (847) 695-3200 ext. 5432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151013001297 IL Practitioner - Clinical Social Worker 8729397807 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Counseling LLCGroup PAC ID 4688021785, 5 clinicians

Practice addresses (Care Compare)

2295 Valley Creek Dr
Suite I
Elgin, IL 60123-2694
Phone (630) 566-4673

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.016361ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brighter Side Counseling LLC Mental Health CurrentSince Dec 31, 2019 Accepting new patients
Valley Psychiatry and Counseling, LLC CurrentSince Aug 16, 2015 Accepting new patients
Valley Counseling, LLC Addiction (Substance Use Disorder) CurrentSince Sep 9, 2022 Accepting new patients

Locations

75 Market St
Ste 12
Elgin, IL 60123
Phone (847) 695-6955

85 Market St
Elgin, IL 60123
Phone (847) 264-4655

41 N McLean Blvd
Elgin, IL 60123
Phone (847) 264-4655

2295 Valley Creek Dr
Ste I
Elgin, IL 60123
Phone (630) 566-4673

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1327190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1992076061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 APPALOOSA CT",
            "city": "SLEEPY HOLLOW",
            "state": "IL",
            "postal_code": "601182517",
            "telephone_number": "847-687-4361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 VALLEY CREEK DR STE I",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601232694",
            "telephone_number": "847-687-4361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1845 Grandstand Pl",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601236603",
            "country_code": "US",
            "telephone_number": "847-695-0484",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75 Market St Ste 12",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601235061",
            "country_code": "US",
            "telephone_number": "847-697-6290",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "77 AIRLITE ST",
            "address_2": "BEHAVIORAL HEALTH UNIT",
            "address_purpose": "LOCATION",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "60123",
            "country_code": "US",
            "telephone_number": "847-695-3200 x5432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRISEBOIS",
        "first_name": "DEBORAH",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW, LMHP, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-22",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.016361",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.