Individual provider Active NPI

Larry W Knopp, MA LCPC

  • Counselor
  • Mt Vernon, IL
National Provider Identifier
1679595458
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
16342 N Il Hwy 37
Mt Vernon, IL 62864
Phone
(618) 242-1510
Fax
(618) 242-0958
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X IL Primary

Addresses

Primary practice location

16342 N Il Hwy 37
Mt Vernon, IL 62864

Mailing address

PO Box 428
Mt Vernon, IL 62864
Phone (618) 242-1510

Other identifiers 2

IdentifierTypeStateIssuer
0004115177OtherILBCBS
295215OtherHEALTHLINK

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241030000555 IL Practitioner - Mental Health Counselor 0840723862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson County ComprehensiveGroup PAC ID 1153350103, 2 clinicians

Practice addresses (Care Compare)

16338 N Il Hwy 37
Mount Vernon, IL 62864-8178
Phone (618) 242-1510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson County Comprehensive CurrentSince Oct 15, 2024 Accepting new patients
Jefferson County Comprehensive Current Accepting new patients

Locations

16338 N IL Highway 37
Mount Vernon, IL 62864
Phone (618) 242-1510

16342 N IL Highway 37
Mount Vernon, IL 62864
Phone (618) 242-1510

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679595458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "MT VERNON",
            "state": "IL",
            "postal_code": "62864",
            "telephone_number": "618-242-1510",
            "fax_number": "618-242-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16342 N IL HWY 37",
            "city": "MT VERNON",
            "state": "IL",
            "postal_code": "62864",
            "telephone_number": "618-242-1510",
            "fax_number": "618-242-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOPP",
        "first_name": "LARRY",
        "middle_name": "W",
        "credential": "MA LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0004115177",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "295215",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Vernon, IL

Sources for this page

Verify at the official NPI Registry.