Deanna Childers, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180.011665 Issued in IL

Practice address

209 W Commercial Dr Ste H
Carterville, IL 62918-2057

Phone

(618) 351-9700

Fax

(618) 351-9701

NPI assigned

Apr 5, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Carbondale Counseling Associates LLC

  • Mental Health Counselor
  • Carterville, IL
  • NPI 1326456484
  NPD (past)
• Kids' Cornerstone, LLC- a Counseling Center

  • Adolescent and Children Mental Health Clinic/Center
  • Carbondale, IL
  • NPI 1447461587
  NPD (past)

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1891228920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2625",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629022625",
            "telephone_number": "618-351-9700",
            "fax_number": "618-351-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W COMMERCIAL DR STE H",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629182057",
            "telephone_number": "618-351-9700",
            "fax_number": "618-351-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "DEANNA",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-05",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.012084",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.011665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Centerstone of Illinois Inc
• Centerstone of Illinois, Inc
• Centerstone of Illinois, Inc
• John Chaney
• Mary K Chapman, NP
• Lakshmi Manogna Chintalacheruvu, MD
• Christian Social Services of Illinois
• Hunter Church
• Shoshana B Church, PA
• City of Carterville

• 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 May 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.