Individual provider Active NPI

Veronica Durdello, LCSW

  • Mental Health Counselor
  • Waterloo, IL
National Provider Identifier
1629510367
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
988 N Illinois Route 3
Waterloo, IL 62298-1000
Phone
(618) 939-4444
Fax
(618) 939-4181
NPI assigned
Nov 11, 2016
Sex
Female
Sole proprietor
No

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2017015587MOMDClinical Social Worker

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2017015587 MO
Mental Health Counselor 101YM0800X Primary

Addresses

NPPES NPI Registry

Primary practice location

988 N Illinois Route 3
Waterloo, IL 62298-1000

Mailing address

988 N Illinois Route 3
PO Box 146
Waterloo, IL 62298-1000
Phone (618) 939-4444

Other practice location 1

4066 Dunnica Ave
Saint Louis, MO 63116-3510
Phone (636) 224-1700

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 28, 2026.

{
    "created_epoch": "1478822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1629510367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988 N ILLINOIS ROUTE 3",
            "address_2": "PO BOX 146",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981000",
            "telephone_number": "618-939-4444",
            "fax_number": "618-939-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988 N ILLINOIS ROUTE 3",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981000",
            "telephone_number": "618-939-4444",
            "fax_number": "618-939-4181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4066 Dunnica Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631163510",
            "country_code": "US",
            "telephone_number": "636-224-1700",
            "fax_number": "314-535-5917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DURDELLO",
        "first_name": "VERONICA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-11",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2017015587",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IL

Sources for this page

Verify at the official NPI Registry.