Individual provider Active NPI

Heather L Teteak-Berg, LCPC, NCC, CCTP

  • Professional Counselor
  • Naperville, IL
National Provider Identifier
1619174489
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180-000428 Issued in IL
Practice address
2244 95TH St Unit 218
Naperville, IL 60564-8033
Phone
(630) 677-1849
Fax
(630) 717-1165
NPI assigned
Jun 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180-000428 IL Primary

Addresses

Primary practice location

2244 95TH St Unit 218
Naperville, IL 60564-8033

Mailing address

2244 95TH St Unit 218
Naperville, IL 60564-8033
Phone (630) 677-1849

Other identifiers 5

IdentifierTypeStateIssuer
02232187OtherILBLUE CROSS BLUE SHIELD
28872OtherILNCC
211652OtherEVERGREEN CERTIFICATIONS--CERTIFIED CLINICAL TRAUMA PROFESSIONAL
180-000428OtherILLCPC
S-1163OtherASSOCIATION FOR PLAY THERAPY

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

State licenses

LicenseStateTypeSpecialty
180-000428ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Insights Psychotherapy, LTD. Professional CurrentSince Apr 17, 2022 Accepting new patients
Debra J Koopmann & Associates, LLC Past Accepting new patients

Locations

2244 95th St
Unit 218
Naperville, IL 60564
Phone (630) 677-1849

1288 Rickert Dr
Ste 220
Naperville, IL 60540
Phone (630) 476-0429

Organizations & group practices 2

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": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1619174489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2244 95TH ST UNIT 218",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648033",
            "telephone_number": "630-677-1849",
            "fax_number": "630-717-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2244 95TH ST UNIT 218",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648033",
            "telephone_number": "630-677-1849",
            "fax_number": "630-717-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETEAK-BERG",
        "first_name": "HEATHER",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LCPC, NCC, CCTP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-000428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "02232187",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCC",
            "identifier": "28872",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERGREEN CERTIFICATIONS--CERTIFIED CLINICAL TRAUMA PROFESSIONAL",
            "identifier": "211652",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCPC",
            "identifier": "180-000428",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASSOCIATION FOR PLAY THERAPY",
            "identifier": "S-1163",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; 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.