Active NPI
Joshua I Shane, LPC
- Professional Counselor
- Peoria, IL
National Provider Identifier
1013824283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 178.005449
- Practice address
- 2101 W Willow Knolls Dr
Peoria, IL 61614-1219 - Phone
- (309) 282-3239
- Fax
- (309) 693-8342
- NPI assigned
- Aug 25, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178.005449 | IL | Primary |
Addresses
Primary practice location
2101 W Willow Knolls Dr
Peoria, IL 61614-1219
Mailing address
2101 W Willow Knolls Dr
Peoria, IL 61614-1219
Phone (309) 282-3239
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787616000000",
"number": "1013824283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 W WILLOW KNOLLS DR",
"city": "PEORIA",
"state": "IL",
"postal_code": "616141219",
"telephone_number": "309-282-3239",
"fax_number": "309-693-8342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 W WILLOW KNOLLS DR",
"city": "PEORIA",
"state": "IL",
"postal_code": "616141219",
"telephone_number": "309-282-3239",
"fax_number": "309-693-8342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANE",
"first_name": "JOSHUA",
"middle_name": "I",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-08-25",
"last_updated": "2026-08-25",
"certification_date": "2026-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178.005449",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.