Jason Andrew Peckels, M.S.ED., L.P.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180005895 Issued in IL

Practice address

433 Phelps Ave
Suite #2
Rockford, IL 61108-2442

Phone

(815) 397-4287

NPI assigned

Apr 7, 2008

Last updated

Jul 16, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Along the Path Counseling Services P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rockford, IL
  • NPI 1306070032
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1568635910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2506 BURRMONT RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071842",
            "telephone_number": "414-801-7905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 PHELPS AVE",
            "address_2": "SUITE #2",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082442",
            "telephone_number": "815-397-4287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECKELS",
        "first_name": "JASON",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "M.S.ED., L.P.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-07",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180005895",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3938-125",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pearson Vision Care, SC
• Charles D Pearson, O.D.
• Drew W Pearson, APN
• James Henry Peck, BC-HIS
• Tracy Barrett Peck, P.T.
• Prakash Pedapati
• Christine M Pedersen, MSPT
• Pediatric Associates of Rockford
• Pediatric Cardiology Associates of Northern Illinois SC
• Pediatric Dentistry of Northern Illinois LTD

• Professional Counselor in Rockford, IL
• Providers in Rockford, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.