Christine Kohut, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149012095 Issued in IL

Practice address

400 5TH St Ste 197
Peru, IL 61354-2876

Phone

(815) 617-9420

NPI assigned

Sep 20, 2009

Last updated

Sep 23, 2022By 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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 6, 2022 through May 6, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Creating Change Counseling Center LLC

  • Clinical Social Worker
  • Peru, IL
  • NPI 1407597743
  NPD Authorized official

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

{
    "created_epoch": "1253404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1689908972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 5TH ST STE 197",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613542876",
            "telephone_number": "815-617-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 5TH ST STE 197",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613542876",
            "telephone_number": "815-617-9420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHUT",
        "first_name": "CHRISTINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-20",
        "last_updated": "2022-09-23",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149012095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Won Yang Kim, M.D.
• Robert S Kinsella, D.O.
• Kamal Kishore, M.D.
• Gary Joseph Kistenfeger, PT
• Pamela M Koehler, CNM
• Robert James Koogler, M.D.
• Steve Korsan, MS, ATC
• Tracy Louise Kotecki
• Terrence Phillip Kunkel, DDS
• Joseph G. Kunnel, D.D.S., M.S., PHD.

• Clinical Social Worker in Peru, IL
• Providers in Peru, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.