Kay Elizabeth Blankenship

Individual provider Active NPI Mental Health Counselor · Washington, IL

NPI 1750857744 · NPPES record last updated Oct 17, 2018

Key facts

NPI
1750857744
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
180.010800 (IL)
Practice address
100 Hillcrest Dr Ste E
Washington, IL 61571-2227
Phone
(309) 444-2800
Fax
(309) 444-2866
NPI assigned
Oct 17, 2018
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Mental Health Counselor
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balanced (10 clinicians)

Practice addresses (Care Compare)

100 Hillcrest Dr
Suite C
Washington, IL 61571-2227
Phone (309) 444-2800

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 IDStateProvider typePAC IDDetails
I20240401000137 IL Practitioner - Mental Health Counselor 6103274741 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
180.010800ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Current
since Jan 22, 2024
Accepting new patients

Locations

100 Hillcrest Dr
Ste C
Washington, IL 61571
Phone (309) 444-2800

100 Hillcrest Dr
Ste E
Washington, IL 61571
Phone (248) 515-4735

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180.010800 IL Yes

Addresses

Primary practice location

100 Hillcrest Dr Ste E
Washington, IL 61571-2227

Mailing address

590 County Road 1625 E
Congerville, IL 61729-9520
Phone (219) 869-9698

Other providers in Washington, IL

All providers in Washington, IL · Mental Health Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.