Theresa Boyd, MS, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180.014826 Issued in IL

Practice address

403 Municipal Dr
Carterville, IL 62918-2042

Phone

(855) 608-3560

Fax

(618) 956-9349

NPI assigned

Dec 23, 2014

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Centerstone of Illinois IncGroup PAC ID 2961545173, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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 and National Provider Directory roles.

• Centerstone of Illinois, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Frankfort, IL
  • NPI 1053455667
  Medicare reassignment Care Compare group NPD
• Centerstone of Illinois, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Alton, IL
  • NPI 1033570262
  NPD
• Hamilton Center Inc.

  • Methadone Clinic
  • Vincennes, IN
  • NPI 1265053854
  NPD (past)
• Hamilton Center, Inc.

  • Community/Behavioral Health Agency
  • Terre Haute, IN
  • NPI 1649007774
  NPD (past)

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1821486044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 W MAIN ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628962210",
            "telephone_number": "618-937-6483",
            "fax_number": "618-937-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 MUNICIPAL DR",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629182042",
            "telephone_number": "855-608-3560",
            "fax_number": "618-956-9349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "THERESA",
        "name_prefix": "Mrs.",
        "credential": "MS, LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-23",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.014826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melonie Elizabeth Blair-Fabian, DCSW
• Martha Ann Blankenship, MSW,LSW
• Suzanne Blankenship
• Cathy D Bless, APN
• Cassie Boyd
• Kelli Patrice Bradbury, DPT
• Giovante Bradley, AAS, RSA
• Jodi Bradley, ADN, RN
• Conner Butler
• Carbondale Counseling Associates LLC

• Mental Health Counselor in Carterville, IL
• Providers in Carterville, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.