Individual provider Active NPI

Rachel Bunyard

  • Professional Counselor
  • Champaign, IL
National Provider Identifier
1417506916
Registry record updated Sep 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.009690 Issued in IL
Practice address
309 W Clark St
Champaign, IL 61820-4637
Phone
(217) 398-9066
Fax
(217) 398-9077
NPI assigned
Sep 6, 2019
Last updated
Sep 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178.009690 IL Primary

Addresses

Primary practice location

309 W Clark St
Champaign, IL 61820-4637

Mailing address

309 W Clark St
Champaign, IL 61820-4637

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
I20240401002583 IL Practitioner - Mental Health Counselor 9032557780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kevin Elliott Counseling PCGroup PAC ID 0143226860, 12 clinicians

Practice addresses (Care Compare)

2001 Philo Rd
Urbana, IL 61802-8007
Phone (217) 398-9066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178.009690ILMDProfessional Counselor

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": "1567728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1417506916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 W CLARK ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618204637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 W CLARK ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618204637",
            "telephone_number": "217-398-9066",
            "fax_number": "217-398-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNYARD",
        "first_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-06",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.009690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.