The Antioch Group, Inc.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

071-004483 Issued in IL

Legal business name

THE ANTIOCH GROUP, INC.

Practice address

6615 N. Big Hollow Rd.
Peoria, IL 61615-2451

Phone

(309) 692-6622

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Shelley Wilson

Title

Credentialing/Billing Specialist

Phone

(309) 692-6622

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patricia J Edwards, LCSW

  • Social Worker
  • Peoria, IL
  • NPI 1356444913
  Medicare reassignment Care Compare group NPD
• Steven Allen Hamon, PHD

  • Psychologist
  • Peoria, IL
  • NPI 1174626782
  Medicare reassignment Care Compare group NPD
• Martin R Hanson, LCPC

  • Counselor
  • Peoria, IL
  • NPI 1811090426
  Medicare reassignment Care Compare group NPD
• Patricia A Poertner, LCPC

  • Counselor
  • Peoria, IL
  • NPI 1356444970
  Medicare reassignment Care Compare group NPD
• Kevin Siscoe, LCPC

  • Professional Counselor
  • Peoria, IL
  • NPI 1043632524
  Medicare reassignment Care Compare group NPD
• Barbara L Toohill, PSY.D.

  • Clinical Psychologist
  • Peoria, IL
  • NPI 1205127784
  Medicare reassignment Care Compare group NPD
• Jonna Lynn Tyler, LCPC RPTS

  • Counselor
  • Peoria, IL
  • NPI 1558464164
  Medicare reassignment Care Compare group NPD
• Jason Woodford, LCPC

  • Professional Counselor
  • Peoria, IL
  • NPI 1740669761
  Medicare reassignment Care Compare group NPD
• Lindsay Kristine Call, LCPC

  • Professional Counselor
  • Peoria, IL
  • NPI 1730789611
  Medicare reassignment NPD
• Angella Maria Lewis, LCPC

  • Professional Counselor
  • Peoria, IL
  • NPI 1356088728
  Medicare reassignment NPD
• Jessie Anna Miller, LCSW

  • Clinical Social Worker
  • Peoria, IL
  • NPI 1700547148
  Medicare reassignment NPD
• Heidi A Grafton, LCSW

  • Clinical Social Worker
  • Peoria, IL
  • NPI 1932793049
  NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727913600000",
    "number": "1801993142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6615 N. BIG HOLLOW RD.",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152451",
            "telephone_number": "309-692-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6615 N. BIG HOLLOW RD.",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152451",
            "telephone_number": "309-692-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ANTIOCH GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_title_or_position": "CREDENTIALING/BILLING SPECIALIST",
        "authorized_official_telephone_number": "309-692-6622"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071-004483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine L Tharenos, MD
• Manisha Tharoor, M.D
• Dakoda Marie Tharp, RBT
• Summer Darlene Tharp
• That Therapy Place, LLC
• The Bleeding and Clotting Disorders Institute
• The Bleeding and Clotting Disorders Institute
• The Bleeding and Clotting Disorders Institute
• The Bleeding and Clotting Disorders Institute
• The Center for Youth and Family Solutions

• Psychologist in Peoria, IL
• Providers in Peoria, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.