NPIMap

Organization Active NPI

Summit Family Therapy PLLC

  • Professional Counselor
  • Peoria, IL
National Provider Identifier
1548704372
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
SUMMIT FAMILY THERAPY PLLC
Practice address
7210 N Villa Lake Dr Ste C
Peoria, IL 61614-8290
Phone
(309) 713-1485
Fax
(309) 419-4328
NPI assigned
Dec 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Authorized official

Name
Dr. Courtney Stivers, PHD LMFTNPI 1275713331
Title
Marriage & Family Therapist/Owner
Phone
(309) 713-1485

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
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

7210 N Villa Lake Dr Ste C
Peoria, IL 61614-8290

Mailing address

7210 N Villa Lake Dr Ste C
Peoria, IL 61614-8290
Phone (309) 713-1485

National Provider Directory

National Provider Directory

Locations

1717 W Candletree Dr
Ste B
Peoria, IL 61614
Phone (309) 713-1485

7210 N Villa Lake Dr
Ste C
Peoria, IL 61614
Phone (309) 713-1485

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635811200000",
    "number": "1548704372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7210 N VILLA LAKE DR STE C",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148290",
            "telephone_number": "309-713-1485",
            "fax_number": "309-419-4328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7210 N VILLA LAKE DR STE C",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148290",
            "telephone_number": "309-713-1485",
            "fax_number": "309-419-4328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT FAMILY THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-13",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A",
        "authorized_official_last_name": "STIVERS",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "MARRIAGE & FAMILY THERAPIST/OWNER",
        "authorized_official_telephone_number": "309-713-1485",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD LMFT"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "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 Nov 2, 2021; 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.