Active NPI
Kelli Deanne Maquet, MS LCPC
- Counselor
- Pontiac, IL
National Provider Identifier
1881656742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 180002295
- Practice address
- 920 W Custer Ave
Pontiac, IL 61764-1067 - Phone
- (815) 844-6109
- NPI assigned
- Apr 5, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 180002295 | IL | Primary |
Addresses
Primary practice location
920 W Custer Ave
Pontiac, IL 61764-1067
Mailing address
PO Box 768
Pontiac, IL 61764-0768
Phone (815) 844-6109
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180002295 | IL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719446400000",
"number": "1881656742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 768",
"city": "PONTIAC",
"state": "IL",
"postal_code": "617640768",
"telephone_number": "815-844-6109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 W CUSTER AVE",
"city": "PONTIAC",
"state": "IL",
"postal_code": "617641067",
"telephone_number": "815-844-6109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAQUET",
"first_name": "KELLI",
"middle_name": "DEANNE",
"name_prefix": "Ms.",
"credential": "MS LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-05",
"last_updated": "2024-06-27",
"certification_date": "2024-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": "180002295",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.