Active NPI
Rachel Kent
- Professional Counselor
- Maryville, IL
National Provider Identifier
1891330585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180.011908
- Practice address
- 6201 W Main St
Maryville, IL 62062-6870 - Phone
- (618) 977-6252
- NPI assigned
- Nov 17, 2019
- Last updated
- Nov 17, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180.011908 | IL | Primary |
Addresses
Primary practice location
6201 W Main St
Maryville, IL 62062-6870
Mailing address
904 Stone Briar Dr
O Fallon, IL 62269-6981
Phone (618) 558-9035
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 |
|---|---|---|---|
| 180.011908 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Advanced Behavioral Health PLLC | Professional | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Professional Counselor
- Swansea, IL
- NPI 1588437636
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573948800000",
"number": "1891330585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "904 STONE BRIAR DR",
"city": "O FALLON",
"state": "IL",
"postal_code": "622696981",
"telephone_number": "618-558-9035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6201 W MAIN ST",
"city": "MARYVILLE",
"state": "IL",
"postal_code": "620626870",
"telephone_number": "618-977-6252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENT",
"first_name": "RACHEL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-17",
"last_updated": "2019-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180.011908",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maryville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.