Active NPI
Peggy Louise Burchard-Ballard, MA
- Professional Counselor
- Quincy, IL
National Provider Identifier
1598075590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 178.007358
- Practice address
- 205 S 24TH St
Simon Cottage
Quincy, IL 62301-4446 - Phone
- (217) 222-0034
- Fax
- (217) 222-3865
- NPI assigned
- Oct 12, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178.007358 | IL | Primary |
Addresses
Primary practice location
205 S 24TH St
Simon Cottage
Quincy, IL 62301-4446
Mailing address
205 S 24TH St
Simon Cottage
Quincy, IL 62301-4446
Phone (217) 222-0034
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.007358 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305763200000",
"number": "1598075590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 S 24TH ST",
"address_2": "SIMON COTTAGE",
"city": "QUINCY",
"state": "IL",
"postal_code": "623014446",
"telephone_number": "217-222-0034",
"fax_number": "217-222-3865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 S 24TH ST",
"address_2": "SIMON COTTAGE",
"city": "QUINCY",
"state": "IL",
"postal_code": "623014446",
"telephone_number": "217-222-0034",
"fax_number": "217-222-3865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURCHARD-BALLARD",
"first_name": "PEGGY",
"middle_name": "LOUISE",
"name_prefix": "Ms.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-12",
"last_updated": "2011-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178.007358",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Quincy, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.