Constance Bracey, LCP
Individual provider Active NPI Professional Counselor · Galesburg, IL
NPI 1740175462 · NPPES record last updated Jun 11, 2025
Key facts
- NPI
- 1740175462
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 178.019552 (IL)
- Practice address
- 575 N Kellogg St Ste 4
Galesburg, IL 61401-7609 - Phone
- (309) 343-0800
- NPI assigned
- Jun 11, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Crossroads Counseling and Life Coaching LLC
Practice addresses (Care Compare)
575 N Kellogg St
Suite 4
Galesburg, IL 61401-7609
Phone (309) 343-0800
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251201000232 | IL | Practitioner - Mental Health Counselor | 1456844380 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.019552 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crossroads Counseling and Life Coaching LLC | Professional | Current |
Accepting new patients |
Locations
575 N Kellogg St
Ste 4
Galesburg, IL 61401
Phone (309) 343-0800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178.019552 | IL | Yes |
Addresses
Primary practice location
575 N Kellogg St Ste 4
Galesburg, IL 61401-7609
Mailing address
575 N Kellogg St Ste 4
Galesburg, IL 61401-7609
Phone (309) 343-0800
Other providers in Galesburg, IL
- Ryan James Bonham
- Sara Kimberly Bosworth
- Darcy D Bouchard
- John S Boydstun
- Veronika Agnieszka Bozek Webber
- Letiya Bradford
- Alexandra Marie Braet
- Kerry Bramlett
- Bravo Care of Galesburg Inc
- Bridgeway Inc
All providers in Galesburg, IL · Professional Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.