Organization Active NPI

Sinclair Counseling & Therapy Services, LLC

  • Clinical Social Worker
  • Peoria, IL
National Provider Identifier
1386395952
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SINCLAIR COUNSELING & THERAPY SERVICES, LLC
Practice address
5016 N University St Ste 101
Peoria, IL 61614-4763
Phone
(309) 863-5590
Fax
(309) 453-6276
NPI assigned
Jan 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Authorized official

Name
Mrs. Angela Kristi Sinclair Hawley, LCSWNPI 1306136189
Title
Managing Member
Phone
(309) 863-5590

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

5016 N University St Ste 101
Peoria, IL 61614-4763

Mailing address

119 Stonecrop Rd
Morton, IL 61550-3155
Phone (309) 863-5590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220208001211 IL Part B Supplier - Clinic/Group Practice 3870986292 Receives reassigned benefits from 1 practitioner
Practice locations: Peoria, IL

National Provider Directory

National Provider Directory

Locations

5016 N University St
Ste 101
Peoria, IL 61614
Phone (309) 208-2329

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1642118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642118400000",
    "number": "1386395952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 STONECROP RD",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615503155",
            "telephone_number": "309-863-5590",
            "fax_number": "309-453-6276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5016 N UNIVERSITY ST STE 101",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144763",
            "telephone_number": "309-863-5590",
            "fax_number": "309-453-6276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SINCLAIR COUNSELING & THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-14",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A",
        "authorized_official_last_name": "SINCLAIR HAWLEY",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "KRISTI",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "309-863-5590",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.