Individual provider Active NPI

William David Agor, PSYD, LCPC

  • Professional Counselor
  • Plainfield, IL
National Provider Identifier
1104832427
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
24402 W Lockport Rd
Unitr 2B
Plainfield, IL 60544-4206
Phone
(630) 621-5824
Fax
(815) 230-3652
NPI assigned
Jul 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X IL Primary

Addresses

Primary practice location

24402 W Lockport Rd
Unitr 2B
Plainfield, IL 60544-4206

Mailing address

1708 Sierra Highlands CT
Plainfield, IL 60586-5934
Phone (815) 254-7655

Other identifiers 1

IdentifierTypeStateIssuer
00022322754OtherILBCBS PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111114000528 IL Practitioner - Clinical Psychologist 4688848484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Agor Behavioral Health Services, Inc.Group PAC ID 9133393937, 8 clinicians

Practice addresses (Care Compare)

24402 W Lockport St
Suite 215
Plainfield, IL 60544-4206
Phone (630) 621-5824

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Agor Behavioral Health Services, Inc. CurrentSince Jul 2, 2011 Accepting new patients

Locations

24402 W Lockport St
Ste 215
Plainfield, IL 60544
Phone (630) 621-5824

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104832427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 SIERRA HIGHLANDS CT",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605865934",
            "telephone_number": "815-254-7655",
            "fax_number": "815-230-3652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24402 W LOCKPORT RD",
            "address_2": "UNITR 2B",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605444206",
            "telephone_number": "630-621-5824",
            "fax_number": "815-230-3652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGOR",
        "first_name": "WILLIAM",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PSYD, LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "00022322754",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IL

Sources for this page

Verify at the official NPI Registry.