Dehvin White-Peck

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180013334 Issued in IL

Practice address

1324 Harvest Dr
Crest Hill, IL 60403-0956

Phone

(770) 510-6469

NPI assigned

Aug 23, 2016

Sex

Male

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

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.

• Premise Health of Illinois Medical PC

  • Primary Care Clinic/Center
  • Mount Vernon, IL
  • NPI 1427366921
  NPD

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

{
    "created_epoch": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1164977807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 HARVEST DR",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604030956",
            "telephone_number": "770-510-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 HARVEST DR",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604030956",
            "telephone_number": "770-510-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE-PECK",
        "first_name": "DEHVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-23",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180013334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walgreen Co.
• Chun Wang, OT
• Holbert Watson, LCSW
• Kelly Weidner
• Sharmeka Shanta White-Peck, PMHNP-BC
• Carolyn Whitfield, DPM
• Will County Chiropractic & Rehab Center, LLC
• Will County Health & Wellness Center SC
• Will County Health and Wellness

• Professional Counselor in Crest Hill, IL
• Providers in Crest Hill, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.