Active NPI
Mary Elizabeth Phillips, MA
- Counselor
- Alton, IL
National Provider Identifier
1265504302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 180-002722
- Practice address
- 611 W. Delmar
Alton, IL 62002 - Phone
- (618) 806-8822
- Fax
- (618) 589-2205
- NPI assigned
- Nov 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 180-002722 | IL | Primary |
Addresses
Primary practice location
611 W. Delmar
Alton, IL 62002
Mailing address
1906 Summerfield LN
Godfrey, IL 62035-1699
Phone (618) 467-2928
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180-002722 | IL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396310400000",
"number": "1265504302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1906 SUMMERFIELD LN",
"city": "GODFREY",
"state": "IL",
"postal_code": "620351699",
"telephone_number": "618-467-2928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 W. DELMAR",
"city": "ALTON",
"state": "IL",
"postal_code": "62002",
"telephone_number": "618-806-8822",
"fax_number": "618-589-2205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "MARY",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-14",
"last_updated": "2014-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": "180-002722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.