Gerald L Carreon, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

166 000856 Issued in IL

Practice address

1601 West Jackson Street
Suite 104
Macomb, IL 61455

Phone

(309) 575-3222

Fax

(309) 404-8000

NPI assigned

Sep 24, 2012

Sex

Male

Sole proprietor

No

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.

• South Liberty Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rushville, IL
  • NPI 1679224075
  NPD Authorized official
• Lakeview Medical & Psychiatric Healthcare LLC

  • Psychiatry Physician
  • Macomb, IL
  • NPI 1942656749
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 5, 2018.

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1295086734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WEST JACKSON STREET",
            "address_2": "SUITE 104",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "61455",
            "telephone_number": "309-575-3222",
            "fax_number": "309-404-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WEST JACKSON STREET",
            "address_2": "SUITE 104",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "61455",
            "telephone_number": "309-575-3222",
            "fax_number": "309-404-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARREON",
        "first_name": "GERALD",
        "middle_name": "L",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-24",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166 000856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Ruth Burke
• Brandon James Burnett, APRN CNP
• Trudy Maria Buster, MSN, APN, CNP, NP-C
• Susanne Carol Campbell, APN, FNP-BC
• Edwin L Card, MD
• Anna Casali
• Isabelo Christopher Castillo, M.D.
• Chad C Cerullo, MS, LAT, ATC
• Gloria Y Cheng, MD
• Tuangui K Cheng, MD

• All providers in Macomb, IL
• Marriage & Family Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2018; 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.