Evonne M. Kuckuck, LCPC, ATR

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180-004352 Issued in IL

Practice address

552 Edwardsville Rd
Troy, IL 62294-1338

Phone

(618) 531-2435

NPI assigned

Nov 17, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Ms. Evonne M. Jenkins Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• New Horizons Behavioral Health, LLC

  • Mental Health Counselor
  • Collinsville, IL
  • NPI 1841352150
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1184798753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "534 COVENTRY RD",
            "city": "TROY",
            "state": "IL",
            "postal_code": "622941743",
            "telephone_number": "618-531-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 EDWARDSVILLE RD",
            "city": "TROY",
            "state": "IL",
            "postal_code": "622941338",
            "telephone_number": "618-531-2435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCKUCK",
        "first_name": "EVONNE",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "LCPC, ATR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-004352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS  PPO",
            "identifier": "06032019",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK  HMO & PPO",
            "identifier": "670554",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVONNE",
            "last_name": "JENKINS",
            "middle_name": "M.",
            "prefix": "MS.",
            "credential": "LCPC, ATR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emma Kiesling
• Mykenzie Kloess
• Lesley Kolesa, COTA
• Lexi Kremer-Callahan, MD
• Katelin A Krystowiak, MD
• Kurt D James DDS PC
• Patricia Lane
• Arthur Langston, D.C.
• Melissa Ann Laskowski
• Sharon Lee Layeski, RBT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; 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.