Gwen Vana, QMHP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

323 W Mulberry St
Watseka, IL 60970-1568

Phone

(815) 432-5241

Fax

(815) 432-4537

NPI assigned

Aug 16, 2012

Last updated

Aug 16, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Clinical Social Worker

Education

Loyola University of Chicago, Stritch School of Medicine, 2012

Medicare assignment

May accept Medicare assignment

Group practices

TMH Behavioral Services PCGroup PAC ID 2264737618, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• TMH Behavioral Services P.C.

  • Adult Mental Health Clinic/Center
  • Chicago, IL
  • NPI 1164997284
  Medicare reassignment Care Compare group NPD
• TMH Behavioral Services P.C.

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1871951988
  NPD

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

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345075200000",
    "number": "1669720991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 W MULBERRY ST",
            "address_2": "PO BOX 322",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 W MULBERRY ST",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701568",
            "telephone_number": "815-432-5241",
            "fax_number": "815-432-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANA",
        "first_name": "GWEN",
        "credential": "QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-16",
        "last_updated": "2012-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John C Tricou, M.D.
• Barbara Trist, LCSW
• Margaret Ullrich
• V. Aravind Reddy M.D.P.C.
• Katherine Anne Van Hoveln, NP-C
• Mary Patricia Varboncouer
• Destyne Velazquez
• Volunteer Services of Iroquois County
• Erica L Wahls, MOT, OTR/L
• Walmart Inc.

• Professional Counselor in Watseka, IL
• Providers in Watseka, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.