NPIMap

Organization Active NPI

Therapeutic, Education, and Career Services, Inc.

Doing business as Your Time To Thrive

  • Counselor
  • Marion, IL
National Provider Identifier
1043631351
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
THERAPEUTIC, EDUCATION, AND CAREER SERVICES, INC.
Doing business as
Your Time To Thrive
Practice address
4505 W de Young St
Ste 203 C
Marion, IL 62959-6295
Phone
(618) 292-1663
Fax
(618) 846-4381
NPI assigned
Jan 5, 2014
Last updated
Apr 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Authorized official

Name
Evonne Lanae Stephenson, LCPCNPI 1982914644
Title
Director
Phone
(618) 292-1663

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary
Psychologist 103T00000X NU
Social Worker 104100000X NU
Massage Therapist 225700000X NU

Addresses

Primary practice location

4505 W de Young St
Ste 203 C
Marion, IL 62959-6295

Mailing address

4505 W Deyoung St Ste 203C
Marion, IL 62959-5899
Phone (618) 292-1663

Other names 1

  • Your Time To Thrive Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190820002466 IL Part B Supplier - Clinic/Group Practice 1355679010 Receives reassigned benefits from 8 practitioners
Practice locations: Carbondale, IL; Marion, IL; Mount Vernon, IL; Salem, IL; Shobonier, IL; Vandalia, IL

National Provider Directory

National Provider Directory

Locations

1001 N Beadle Dr
Ste 203C
Carbondale, IL 62901
Phone (800) 457-7790

4505 W Deyoung St
Ste 203C
Marion, IL 62959
Phone (618) 283-2222

403 N 42nd St
Ste C
Mount Vernon, IL 62864
Phone (618) 242-1070

1121 N 6th St
Vandalia, IL 62471
Phone (618) 283-2222

1121 N 6th St
Ste 203C
Vandalia, IL 62471
Phone (618) 283-2222

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1388880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651190400000",
    "number": "1043631351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 W DEYOUNG ST STE 203C",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595899",
            "telephone_number": "618-292-1663",
            "fax_number": "844-270-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 W DE YOUNG ST",
            "address_2": "STE 203 C",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629596295",
            "telephone_number": "618-292-1663",
            "fax_number": "618-846-4381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC, EDUCATION, AND CAREER SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-05",
        "last_updated": "2022-04-29",
        "certification_date": "2021-09-16",
        "status": "A",
        "authorized_official_last_name": "STEPHENSON",
        "authorized_official_first_name": "EVONNE",
        "authorized_official_middle_name": "LANAE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "618-292-1663",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Your Time To Thrive",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Your Time To Thrive",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.