Individual provider Active NPI

Gina Michelle Owens-Spahn, LCPC

  • Professional Counselor
  • Peoria, IL
National Provider Identifier
1124358221
Registry record updated Sep 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180-004587 Issued in IL
Practice address
320 E Armstrong Ave
Peoria, IL 61603-3172
Phone
(309) 624-9522
Fax
(309) 624-9555
NPI assigned
Jan 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2013

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 180-004587 IL Primary

Addresses

Primary practice location

320 E Armstrong Ave
Peoria, IL 61603-3172

Mailing address

320 E Armstrong Ave
Peoria, IL 61603-3172
Phone (309) 624-9522

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
I20240109002457 IL Practitioner - Mental Health Counselor 9436500907 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180-004587ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Grow Healthcare Group PA Professional CurrentSince Aug 27, 2024 Accepting new patients
Saint Francis Medical Center Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2021 Accepting new patients
Saint Francis Medical Center CurrentSince Jan 1, 2024 Accepting new patients
Saint Francis Medical Center Professional CurrentSince Jan 1, 2024 Accepting new patients

Locations

605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

320 E Armstrong Ave
Peoria, IL 61603
Phone (309) 624-9587

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378771200000",
    "number": "1124358221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E ARMSTRONG AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033172",
            "telephone_number": "309-624-9522",
            "fax_number": "309-624-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E ARMSTRONG AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033172",
            "telephone_number": "309-624-9522",
            "fax_number": "309-624-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS-SPAHN",
        "first_name": "GINA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-12",
        "last_updated": "2013-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-004587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.