Teresa Macdavitt, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

747 E Etna Rd Unit B
Ottawa, IL 61350-3777

Phone

(815) 993-1614

NPI assigned

Feb 23, 2022

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

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

Specialty

Mental Health Counselor

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Illinois Valley Counseling ServicesGroup PAC ID 0244467066, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Illinois Valley Counseling Services

  • Clinical Social Worker
  • Ottawa, IL
  • NPI 1134568249
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1760138242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 OAK RIDGE DR",
            "city": "LA SALLE",
            "state": "IL",
            "postal_code": "613019648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 E ETNA RD UNIT B",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613503777",
            "telephone_number": "815-993-1614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDAVITT",
        "first_name": "TERESA",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-23",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chenglu Liu, M.D.
• Emily R Long, APN
• Carrie Lynn Lopez, PA
• Terry Wayne Love, D.O.
• Cheryl Marie Lucas McCoy, APRN, CNP
• Lauren Robyn Madon, MSW
• Robert B Maguire, MD
• Matthew Benton Makeever, MA, LPC, NCC
• Stephanie Makos
• Richard Francis Mangold, ED.D.

• Professional Counselor in Ottawa, IL
• Providers in Ottawa, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.