Susan Rae Macdonough, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180013585 Issued in IL

Practice address

1025 Maine St
Quincy, IL 62301-4096

Phone

(217) 222-6550

Fax

(217) 277-2253

NPI assigned

Apr 15, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Susan Rae Porter Former name

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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Quincy Physicians and Surgeons Clinic, PLLCGroup PAC ID 0749192375, 231 clinicians

Practice addresses (Care Compare)

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.

• Quincy Physicians & Surgeons Clinic, PLLC

  • Clinic/Center
  • Quincy, IL
  • NPI 1548234198
  Medicare reassignment Care Compare group NPD
• Quincy Physicians & Surgeons Clinic, PLLC

  • Rural Health Clinic/Center
  • Winchester, IL
  • NPI 1114105749
  NPD
• Quincy Physicians & Surgeons Clinic, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Pittsfield, IL
  • NPI 1871794925
  NPD

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1174186233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014096",
            "telephone_number": "217-222-6550",
            "fax_number": "217-277-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014096",
            "telephone_number": "217-222-6550",
            "fax_number": "217-277-2253"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "141 Communication Dr",
            "address_purpose": "LOCATION",
            "city": "Hannibal",
            "state": "MO",
            "postal_code": "634013670",
            "country_code": "US",
            "telephone_number": "573-603-1460",
            "fax_number": "573-603-1462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACDONOUGH",
        "first_name": "SUSAN",
        "middle_name": "RAE",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2018036478",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180013585",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180013585",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "PORTER",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nathan Lunt
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• Jennifer Ann Lyons
• Nicole Lyons, M.S. CCC-SLP
• Bethany Elizabeth Maas, RDN, LD
• Paula S Mackrides, D.O.
• Austin John Maddy
• Madison Park Christian Church
• Obioma Nnene Maduakor, MD
• Jessica Nicole Maggart

• Professional Counselor in Quincy, IL
• Providers in Quincy, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.