Active NPI
Corey R. Hopson, LCPC
- Professional Counselor
- Peoria Heights, IL
National Provider Identifier
1275764763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180006773
- Practice address
- 712 E War Memorial Dr Ste D
Peoria Heights, IL 61616-7548 - Phone
- (309) 648-2541
- Fax
- (309) 285-8785
- NPI assigned
- Jul 31, 2009
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180006773 | IL | Primary |
Addresses
Primary practice location
712 E War Memorial Dr Ste D
Peoria Heights, IL 61616-7548
Mailing address
712 E War Memorial Dr Ste D
Peoria Heights, IL 61616-7548
Phone (309) 648-2541
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180006773 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575849600000",
"number": "1275764763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "712 E WAR MEMORIAL DR STE D",
"city": "PEORIA HEIGHTS",
"state": "IL",
"postal_code": "616167548",
"telephone_number": "309-648-2541",
"fax_number": "309-285-8785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "712 E WAR MEMORIAL DR STE D",
"city": "PEORIA HEIGHTS",
"state": "IL",
"postal_code": "616167548",
"telephone_number": "309-648-2541",
"fax_number": "309-285-8785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOPSON",
"first_name": "COREY",
"middle_name": "R.",
"name_prefix": "Mr.",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-31",
"last_updated": "2019-12-09",
"certification_date": "2019-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180006773",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria Heights, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.