Active NPI
Tim Dale Monken, MA, LCPC
- Professional Counselor
- Centralia, IL
National Provider Identifier
1639219025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180-002723
- Practice address
- 417 E Calumet St
Centralia, IL 62801-4562 - Phone
- (618) 322-7580
- Fax
- (618) 532-6805
- NPI assigned
- Feb 7, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 180-002723 | IL | Primary |
Addresses
Primary practice location
417 E Calumet St
Centralia, IL 62801-4562
Mailing address
417 E Calumet St
Centralia, IL 62801-4562
Phone (618) 322-7580
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 |
|---|---|---|---|
| 180-002723 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639219025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 E CALUMET ST",
"city": "CENTRALIA",
"state": "IL",
"postal_code": "628014562",
"telephone_number": "618-322-7580",
"fax_number": "618-532-6805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 E CALUMET ST",
"city": "CENTRALIA",
"state": "IL",
"postal_code": "628014562",
"telephone_number": "618-322-7580",
"fax_number": "618-532-6805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONKEN",
"first_name": "TIM",
"middle_name": "DALE",
"credential": "MA, LCPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180-002723",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centralia, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.