Victoria Fetter

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180015113 Issued in IL

Practice address

808 S Eldorado Rd Ste 102
Bloomington, IL 61704-6075

Phone

(888) 428-7890

Fax

(877) 428-7891

NPI assigned

May 21, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Edgewood Clinical Services P.C.Group PAC ID 3971963901, 304 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Edgewood Clinical Services, P.C.

  • Psychologist
  • Naperville, IL
  • NPI 1295914646

  Mental Health

  Medicare reassignment Care Compare group NPD
• Psychology Specialists LTD

  • Clinical Psychologist
  • Bloomington, IL
  • NPI 1053368605

  Counselor

  NPD (past)

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

{
    "created_epoch": "1590019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1003439340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 S ELDORADO RD STE 102",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617046075",
            "telephone_number": "888-428-7890",
            "fax_number": "877-428-7891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 S ELDORADO RD STE 102",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617046075",
            "telephone_number": "888-428-7890",
            "fax_number": "877-428-7891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTER",
        "first_name": "VICTORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-21",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180.015113",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180015113",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180015113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370915481007",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tian Bin Feng, MD
• Rosemary Joda Fenton
• Ashley Ferguson, APN
• Rachel J Ferguson
• Kyle Ferraro, OT
• Kylee Jane Fetzner, RDN
• Jeanette Marie Feucht, MSN CNP
• Kali A Fever, APN, CNP
• Allison Ziegler Fields
• Latayna Alvia Fields

• Mental Health Counselor in Bloomington, IL
• Providers in Bloomington, 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 Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.