Individual provider Active NPI

Craig E Waterstreet, MS ED, NCC, LCPC

  • Counselor
  • Macomb, IL
National Provider Identifier
1295932762
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
180-000746 Issued in IL
Practice address
233 S McArthur St
Macomb, IL 61455-2983
Phone
(309) 833-2255
Fax
(309) 833-2251
NPI assigned
Jun 28, 2007
Last updated
Aug 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 180-000746 IL Primary

Addresses

Primary practice location

233 S McArthur St
Macomb, IL 61455-2983

Mailing address

233 S McArthur St
Macomb, IL 61455-2983
Phone (309) 833-2255

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
I20240207001994 IL Practitioner - Mental Health Counselor 5597940593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

233 S McArthur St
Macomb, IL 61455-2983
Phone (309) 833-2255

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
180-000746ILMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Cares P.C. CurrentSince Dec 11, 2010 Accepting new patients

Locations

233 S McArthur St
Macomb, IL 61455
Phone (309) 833-2255

Organizations & group practices 1

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": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1295932762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 S MCARTHUR ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552983",
            "telephone_number": "309-833-2255",
            "fax_number": "309-833-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 S MCARTHUR ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552983",
            "telephone_number": "309-833-2255",
            "fax_number": "309-833-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERSTREET",
        "first_name": "CRAIG",
        "middle_name": "E",
        "credential": "MS ED, NCC, LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180-000746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, IL

Sources for this page

Verify at the official NPI Registry.