Daniel Osterloo, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

3526 N California Ave Ste 204
Peoria, IL 61603-1164

Phone

(181) 540-8052

NPI assigned

Oct 2, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Stone Bridge Counseling LLC

  • Professional Counselor
  • Peoria, IL
  • NPI 1306464201
  NPD Authorized official

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1104253319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3526 N CALIFORNIA AVE STE 204",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616031164",
            "telephone_number": "181-540-8052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3526 N CALIFORNIA AVE STE 204",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616031164",
            "telephone_number": "181-540-8052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTERLOO",
        "first_name": "DANIEL",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-02",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180010635",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Osf Saint Francis Medical Center
• Osf Saint Francis Medical Center GPR Program
• Osf Saint Francis, Inc
• Osf St. Francis Medical Center
• Kaitlyn Osmulski
• Mallory Osterloo, LCPC
• Sydney Brianne Ostrowsky
• Chukwunenye Kamalu Osuji, M.D.
• Barbara E. Ott, O.D.
• Larry D Otte, D.M.D.

• Mental Health Counselor in Peoria, IL
• Providers in Peoria, 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 Jul 17, 2020; 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.