Active NPI
Colleen M Lareau, LPC
- Mental Health Counselor
- Effingham, IL
National Provider Identifier
1851431092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 178008774
- Practice address
- 604 N 2ND St
Effingham, IL 62401-3324 - Phone
- (217) 685-3739
- NPI assigned
- Feb 7, 2007
- Last updated
- Jan 7, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 178008774 | IL | Primary |
| Cognitive & Behavioral Psychologist | 103TB0200X | 6301013487 | MI | |
| Counseling Psychologist | 103TC1900X | 6301013487 | MI |
Addresses
Primary practice location
604 N 2ND St
Effingham, IL 62401-3324
Mailing address
604 N 2ND St
Effingham, IL 62401-3324
Phone (217) 685-3739
Other practice location 1
6245 Burton St SE
Grand Rapids, MI 49546-6717
Phone (616) 949-9488
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 260D16159 | Other | MI | BCBS GROUP NUMBER |
| 38-2831313 | Other | MI | AGENCY TAX NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178008774 | IL | MD | Mental Health Counselor |
| 6301013487 | MI | MD | Cognitive & Behavioral Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546819200000",
"number": "1851431092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "604 N 2ND ST",
"city": "EFFINGHAM",
"state": "IL",
"postal_code": "624013324",
"telephone_number": "217-685-3739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "604 N 2ND ST",
"city": "EFFINGHAM",
"state": "IL",
"postal_code": "624013324",
"telephone_number": "217-685-3739"
}
],
"practiceLocations": [
{
"address_1": "6245 Burton St SE",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495466717",
"country_code": "US",
"telephone_number": "616-949-9488",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LAREAU",
"first_name": "COLLEEN",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-07",
"last_updated": "2019-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "178008774",
"primary": true
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "MI",
"license": "6301013487",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MI",
"license": "6301013487",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS GROUP NUMBER",
"identifier": "260D16159",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AGENCY TAX NUMBER",
"identifier": "38-2831313",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Effingham, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.