Individual provider Active NPI

Victoria M Christman Kuston, LCPC

  • Professional Counselor
  • Mokena, IL
National Provider Identifier
1750970448
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180012924 Issued in IL
Practice address
9697 191St St Ste 200
Mokena, IL 60448-8617
Phone
(630) 646-6540
Fax
(630) 646-6542
NPI assigned
Jan 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180012924 IL Primary

Addresses

Primary practice location

9697 191St St Ste 200
Mokena, IL 60448-8617

Mailing address

9697 191St St Ste 200
Mokena, IL 60448-8617
Phone (630) 646-6540

Other practice location 1

4331 Lincoln Hwy
Matteson, IL 60443-2404
Phone (708) 748-1951

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
I20240313000223 IL Practitioner - Mental Health Counselor 2163868134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Jan 30, 2024 Accepting new patients
Endeavor Health Medical Group Current Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

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": "1610755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1750970448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9697 191ST ST STE 200",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488617",
            "telephone_number": "630-646-6540",
            "fax_number": "630-646-6542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9697 191ST ST STE 200",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488617",
            "telephone_number": "630-646-6540",
            "fax_number": "630-646-6542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4331 Lincoln Hwy",
            "address_purpose": "LOCATION",
            "city": "Matteson",
            "state": "IL",
            "postal_code": "604432404",
            "country_code": "US",
            "telephone_number": "708-748-1951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISTMAN KUSTON",
        "first_name": "VICTORIA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-16",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180012924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mokena, IL

Sources for this page

Verify at the official NPI Registry.