Agape Counseling, LTD

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

AGAPE COUNSELING, LTD

Practice address

75 E Queenwood Rd
Morton, IL 61550-2985

Phone

(309) 263-5565

Fax

(309) 263-9336

NPI assigned

Nov 18, 2005

Last updated

Aug 18, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Eugene Vaccaro, PSY. DNPI 1144333485

Title

Owner

Phone

(309) 263-5565

Specialties & licenses 11

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elizabeth J Garner, LCSW

  • Clinical Social Worker
  • Morton, IL
  • NPI 1881603611
  Medicare reassignment
• Eugene D Vaccaro, PSYD

  • Clinical Psychologist
  • Morton, IL
  • NPI 1144333485
  Authorized official Same address or phone
• Patrick J. Carroll, LCSW

  • Professional Counselor
  • Normal, IL
  • NPI 1346259140
  NPD (past)
• Kiera Michelle Dymit

  • Counselor
  • Bloomington, IL
  • NPI 1427523695
  NPD (past)
• Crystal Hiser, LCPC

  • Professional Counselor
  • Bloomington, IL
  • NPI 1104904242
  NPD (past)
• Annette M Larsen, LCPC

  • Professional Counselor
  • Normal, IL
  • NPI 1265510507
  NPD (past)
• Jerey Laverne McKinney

  • Mental Health Counselor
  • Bloomington, IL
  • NPI 1083815617
  NPD (past)
• Karen Meany, LPC

  • Professional Counselor
  • Bloomington, IL
  • NPI 1073227419
  NPD (past)
• Michelle L Rolley, MS, LCPC

  • Mental Health Counselor
  • Bloomington, IL
  • NPI 1669626362
  NPD (past)
• Kelsey Trunk, LCSW

  • Clinical Social Worker
  • Bloomington, IL
  • NPI 1447084090
  NPD (past)
• Barry Ufheil, LCPC

  • Counselor
  • Morton, IL
  • NPI 1649893942
  NPD (past)
• Jefferson Williams, LCPC

  • Professional Counselor
  • Bloomington, IL
  • NPI 1891286191
  NPD (past)

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282089600000",
    "number": "1821070434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 E QUEENWOOD RD",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502985",
            "telephone_number": "309-263-5565",
            "fax_number": "309-263-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 E QUEENWOOD RD",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502985",
            "telephone_number": "309-263-5565",
            "fax_number": "309-263-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE COUNSELING, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2010-08-18",
        "status": "A",
        "authorized_official_last_name": "VACCARO",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-263-5565",
        "authorized_official_credential": "PSY. D"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; 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.