Courtney Leigh Stivers, PHD, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

166001031 Issued in IL

Practice address

1717 W Candletree Dr
Suite B
Peoria, IL 61614-1592

Phone

(501) 593-3069

NPI assigned

Nov 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Ms. Courtney Leigh Hirst Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 14, 2024 through Mar 14, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Summit Family Therapy PLLC

  • Professional Counselor
  • Peoria, IL
  • NPI 1548704372
  NPD Authorized official

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1275713331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 W CANDLETREE DR",
            "address_2": "SUITE B",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141592",
            "telephone_number": "501-593-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W CANDLETREE DR",
            "address_2": "SUITE B",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141592",
            "telephone_number": "501-593-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIVERS",
        "first_name": "COURTNEY",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "PHD, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-06",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "A0710079",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P1010069",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AR",
            "license": "A1101007",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166001031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "HIRST",
            "middle_name": "LEIGH",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica M Stewart, CNS
• Kari A Stewart, APN
• Sidney A Stewart, M.D.
• Michelle Lynn Stickelmaier, APN
• Gabriel J Stickling, O.T.
• Ryan Joseph Stivers, PH.D., LMFT, LPC
• Adam John Stocksiek
• Joseph S Stocksiek
• Michelle Stoecker, DPT
• Jessica Christine Stokowski, RN, IBCLC

• Marriage & Family Therapist in Peoria, IL
• Providers in Peoria, IL by specialty
• Marriage & Family Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.