Individual provider Active NPI

Sarah Katherine Robertson, MA

  • Counselor
  • Peoria, IL
National Provider Identifier
1568434306
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
180006038 Issued in IL
Practice address
3716 W Brighton Ave
Peoria, IL 61615-2938
Phone
(309) 692-7755
Fax
(309) 692-2262
NPI assigned
Feb 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Counselor 101Y00000X 180006038 IL Primary

Addresses

Primary practice location

3716 W Brighton Ave
Peoria, IL 61615-2938

Mailing address

1014 Eisenhower Dr
Pekin, IL 61554-1508
Phone (309) 241-4041

Other names 1

  • Mrs. Kate Robertson Other name

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
I20241004001271 IL Practitioner - Mental Health Counselor 4284078437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John Day and Associates, LTDGroup PAC ID 0446201693, 11 clinicians

Practice addresses (Care Compare)

3716 W Brighton Ave
Peoria, IL 61615-2938
Phone (309) 692-7755

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
180006038ILMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
John Day & Associates, LTD Professional CurrentSince Jun 24, 2024 Accepting new patients

Locations

3716 W Brighton Ave
Peoria, IL 61615

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1568434306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 EISENHOWER DR",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615541508",
            "telephone_number": "309-241-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3716 W BRIGHTON AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152938",
            "telephone_number": "309-692-7755",
            "fax_number": "309-692-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "SARAH",
        "middle_name": "KATHERINE",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-06",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180006038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATE",
            "last_name": "ROBERTSON",
            "prefix": "MRS.",
            "credential": "MA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.