PCK Behavioral Health Group

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

PCK BEHAVIORAL HEALTH GROUP

Practice address

47 Katrina LN
Sleepy Hollow, IL 60118-3123

Phone

(224) 699-0196

NPI assigned

Jul 4, 2022

Organization subpart

No

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

Authorized official

Name

Phetsavanh C Coggin, LCPCNPI 1336537745

Title

Owner

Phone

(224) 699-0196

Specialties & licenses 1

Addresses

Other names 1

• PHET C COGGIN LCPC Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 2

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

• Phetsavanh Coggin, LCPC

  • Mental Health Counselor
  • Woodstock, IL
  • NPI 1336537745
  Medicare reassignment Authorized official
• Teresa K Gebhardt, LPC

  • Mental Health Counselor
  • Sleepy Hollow, IL
  • NPI 1801506860
  NPD

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

{
    "created_epoch": "1656892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657065600000",
    "number": "1477286805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 KATRINA LN",
            "city": "SLEEPY HOLLOW",
            "state": "IL",
            "postal_code": "601183123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 KATRINA LN",
            "city": "SLEEPY HOLLOW",
            "state": "IL",
            "postal_code": "601183123",
            "telephone_number": "224-699-0196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCK BEHAVIORAL HEALTH GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-04",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A",
        "authorized_official_last_name": "COGGIN",
        "authorized_official_first_name": "PHETSAVANH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-699-0196",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHET C COGGIN LCPC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Meg Gail Jorgensen, D.N.
• Kerri Lynn Lomax
• Linda Blythe Nemec, PT
• Bernice M Page
• Lauren Paulsen
• Pro Dental Care LTD
• Jacqueline Martina Rios
• Matthew Schumacher, M.A.
• Gerrie Suggs
• Tcpcindustries

• Counselor in Sleepy Hollow, IL
• Providers in Sleepy Hollow, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.