Individual provider Active NPI

Laura Tepen, LPC

  • Professional Counselor
  • Bloomington, IL
National Provider Identifier
1437859089
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.018944 Issued in IL
Practice address
107 E Chestnut St
Bloomington, IL 61701-3009
Phone
(309) 490-3060
NPI assigned
Mar 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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 178.018944 IL Primary

Addresses

Primary practice location

107 E Chestnut St
Bloomington, IL 61701-3009

Mailing address

1612 E Oakland Ave
Bloomington, IL 61701-5618
Phone (217) 671-9454

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

LicenseStateTypeSpecialty
178.018944ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Healing Expressive Arts Center CurrentSince Oct 29, 2023 Accepting new patients
Creative Healing Art Therapy, PLLC Professional CurrentSince Apr 8, 2024 Accepting new patients

Locations

107 E Chestnut St
Bloomington, IL 61701
Phone (309) 490-3060

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1437859089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 E OAKLAND AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617015618",
            "telephone_number": "217-671-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E CHESTNUT ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013009",
            "telephone_number": "309-490-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEPEN",
        "first_name": "LAURA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-03",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.018944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; 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.