Individual provider Active NPI

Louis G. Sisto

  • Mental Health Counselor
  • Carthage, IL
National Provider Identifier
1578873527
Registry record updated Oct 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
607 Buchanan St
Carthage, IL 62321-1401
Phone
(217) 773-3325
Fax
(217) 773-2425
NPI assigned
Oct 8, 2010
Last updated
Oct 8, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

607 Buchanan St
Carthage, IL 62321-1401

Mailing address

700 SE Cross St
Mount Sterling, IL 62353-1561
Phone (217) 773-3325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20240102003383 NV Practitioner - Other (Non-Physician) 6800246992 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fundamental Behavioral Services LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

3035 S Maryland Pkwy
Ste 110
Las Vegas, NV 89109
Phone (702) 751-2547

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286496000000",
    "number": "1578873527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SE CROSS ST",
            "city": "MOUNT STERLING",
            "state": "IL",
            "postal_code": "623531561",
            "telephone_number": "217-773-3325",
            "fax_number": "217-773-2425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 BUCHANAN ST",
            "city": "CARTHAGE",
            "state": "IL",
            "postal_code": "623211401",
            "telephone_number": "217-773-3325",
            "fax_number": "217-773-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISTO",
        "first_name": "LOUIS",
        "middle_name": "G.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-08",
        "last_updated": "2010-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, IL

Sources for this page

Verify at the official NPI Registry.