FAMILY SERVICE AGENCY OF DEKALB COUNTY, INC. (NPI# 1184154007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184154007 |
| Entity Type | Organization |
| Organization Name | FAMILY SERVICE AGENCY OF DEKALB COUNTY, INC. |
| Practice Address |
14 Health Services Dr Dekalb IL 60115-9637 |
| Practice Telephone | (815) 758-8616 |
| Mailing Telephone | 8157588616 |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2017-06-13 |
| Authorized Official Name | TYNISHA CLEGG (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 8157588616 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
17004 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 17004 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598820300 | Family Service Agency of Dekalb County, Inc. | Clinic/Center | 14 Health Services Drive, Dekalb, IL 60115 | 2006-12-22 |
| Street Address |
14 HEALTH SERVICES DR |
| City | DEKALB |
| State | IL |
| Zip Code | 60115-9637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487719100 | Joseph Puleo IIi | Counselor | 14 Health Services Dr, Dekalb, IL 60115 | 2006-12-22 |
| 1467078675 | Emma Louise Busken | Counselor | 14 Health Services Dr, Dekalb, IL 60115-9637 | 2020-06-23 |
| 1639795842 | Sydney Hall | Counselor | 14 Health Services Dr, Dekalb, IL 60115-9637 | 2020-06-23 |
| 1679126742 | Hayley Marie Garcia | Social Worker | 14 Health Services Dr, Dekalb, IL 60115-9637 | 2019-07-18 |
| 1851953913 | Kelly Hess | Social Worker | 14 Health Services Dr, Dekalb, IL 60115-9637 | 2019-06-28 |
| 1144881335 | Bianca Gomez | Counselor | 14 Health Services Dr, Dekalb, IL 60115-9637 | 2019-06-27 |
| 1396306445 | Gillian Moore | Social Worker | 14 Health Services Dr, Dekalb, IL 60115-9637 | 2019-06-27 |
| 1811558240 | Laura Hill | Marriage & Family Therapist | 14 Health Services Dr, Dekalb, IL 60115-9637 | 2019-06-26 |
| 1194386516 | Gabrielle J Moreno | Counselor | 14 Health Services Dr, Dekalb, IL 60115-9637 | 2019-06-26 |
| 1386204170 | Cara Higgins | Social Worker | 14 Health Services Dr, Dekalb, IL 60115-9637 | 2019-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598372179 | Megan Erhart | Counselor | 304 N. 6th Street, Dekalb, IL 60115 | 2020-09-28 |
| 1689141616 | Stephanie Klewin | Psychologist | 631 S 1st Street, Dekalb, IL 60115 | 2018-10-29 |
| 1164902219 | Kimberly Ann Hart | Counselor | 290 N. Annie Glidden Drive, Gh 416, Niu, Dekalb, IL 60115 | 2018-08-17 |
| 1497235824 | Cory David Michael Hayden | Specialist/Technologist | 175 Yordon Center (niu Athletic Training), Dekalb, IL 60115 | 2018-08-15 |
| 1154807808 | Michael John Borak | Pharmacist | 975 S Annie Glidden Road, Schnucks Market Inc, Dekalb, IL 60115 | 2018-07-16 |
| 1184125841 | Candace Schroeffel | Student in an Organized Health Care Education/Training Program | 520 Garden Rd, Dekalb, IL 60115 | 2018-02-27 |
| 1033627583 | Hannah M Studebaker | Massage Therapist | 3266 Sycamore Road, Dekalb, IL 60115 | 2018-01-18 |
| 1649700238 | Jennifer Mangino | Behavioral Analyst | 138 Berkshire Dr, Dekalb, IL 60115 | 2017-06-15 |
| 1003346628 | Victoria Tullock | Counselor | 631 South First St., Dekalb, IL 60115 | 2017-06-15 |
| 1194263848 | Brianna Kraft | Specialist/Technologist | 900 Crane Dr, Dekalb, IL 60115 | 2017-02-02 |
| Find all providers in zip 60115 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528556669 | Associaiton for Individual Development | Clinic/Center | 304 N 6th St Ste C, Dekalb, IL 60115-3484 | 2018-04-24 |
| 1972788925 | Community Support Program/reality House | Clinic/Center | 631 S 1st St, Dekalb, IL 60115-4117 | 2008-01-08 |
| 1750327003 | Ben Gordon Center | Clinic/Center | 12 Health Services Drive, Dekalb, IL 60115 | 2006-06-22 |
| 1306203856 | Dekalb Behavioral Health Foundation, Inc. | Clinic/Center | 631 S 1st St, Dekalb, IL 60115 | 2016-01-27 |
| 1255703450 | Dekalb Behavioral Health Foundation, Inc. | Clinic/Center | 12 Health Services Dr, Dekalb, IL 60115 | 2015-10-27 |
| 1700037512 | Ben Gordon Center | Clinic/Center | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2008-10-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.