Individual provider Active NPI

Ellyn E Lowry, MS, LCPC

  • Mental Health Counselor
  • Alton, IL
National Provider Identifier
1194244178
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.012651 Issued in IL
Practice address
2615 Edwards St
Alton, IL 62002-3915
Phone
(618) 462-2331
Fax
(618) 462-2504
NPI assigned
Sep 12, 2017
Last updated
Feb 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180.012651 IL Primary

Addresses

Primary practice location

2615 Edwards St
Alton, IL 62002-3915

Mailing address

902 W Main St
West Frankfort, IL 62896-2210
Phone (618) 937-6483

Other names 1

  • Ellyn Busker Former name

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
I20231227000114 IL Practitioner - Mental Health Counselor 9931559465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centerstone of Illinois IncGroup PAC ID 2961545173, 44 clinicians

Practice addresses (Care Compare)

2615 Edwards St
Alton, IL 62002-3915
Phone (618) 462-2331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
180.012651ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Life Consultants, Inc PastSince Dec 11, 2004 Accepting new patients

Organizations & group practices 2

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": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1194244178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 W MAIN ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628962210",
            "telephone_number": "618-937-6483",
            "fax_number": "618-937-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 EDWARDS ST",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620023915",
            "telephone_number": "618-462-2331",
            "fax_number": "618-462-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWRY",
        "first_name": "ELLYN",
        "middle_name": "E",
        "credential": "MS, LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-12",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.012651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLYN",
            "last_name": "BUSKER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alton, IL

Sources for this page

Verify at the official NPI Registry.