Jerey Laverne McKinney

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

211 N. Veterans Pkwy. Suite #1
Bloomington, IL 61704

Phone

(309) 663-2229

NPI assigned

May 30, 2007

Reactivated

Oct 13, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

  NPD
• Agape Counseling, LTD

  • Psychologist
  • Morton, IL
  • NPI 1821070434

  Mental Health

  NPD (past)
• Psychology Specialists LTD

  • Clinical Psychologist
  • Bloomington, IL
  • NPI 1053368605
  NPD (past)

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1083815617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N. VETERANS PKWY. SUITE 1",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61704",
            "telephone_number": "309-663-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N. VETERANS PKWY. SUITE #1",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61704",
            "telephone_number": "309-663-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "JEREY",
        "middle_name": "LAVERNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "deactivation_date": "2012-07-26",
        "reactivation_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin L McGuire, LCPC
• Jillian M. McHood, FNP
• Natalie M McKee, AU.D.
• Diane L McKillop
• Jessica A McKinley-Simpson
• Scott William McLain, MD
• McLean County Anesthesiology, LTD.
• McLean County Center for H S
• McLean County Center for Human Services, Inc
• McLean County Center for Human Services, Inc

• 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 Oct 13, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.