Individual provider Active NPI

Teresa Lynnette Peplow, COUNSELOR

  • Counselor
  • Metamora, IL
National Provider Identifier
1063995348
Registry record updated Sep 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
178007084 Issued in IL
Practice address
586 Tazewood Rd
Metamora, IL 61548-7304
Phone
(309) 264-7627
NPI assigned
Sep 12, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 178007084 IL Primary

Addresses

Primary practice location

586 Tazewood Rd
Metamora, IL 61548-7304

Mailing address

586 Tazewood Rd
Metamora, IL 61548-7304
Phone (309) 264-7627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
178007084ILMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1063995348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "586 TAZEWOOD RD",
            "city": "METAMORA",
            "state": "IL",
            "postal_code": "615487304",
            "telephone_number": "309-264-7627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "586 TAZEWOOD RD",
            "city": "METAMORA",
            "state": "IL",
            "postal_code": "615487304",
            "telephone_number": "309-264-7627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEPLOW",
        "first_name": "TERESA",
        "middle_name": "LYNNETTE",
        "credential": "COUNSELOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-12",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178007084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metamora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.