Individual provider Active NPI

Teri McKean, LCSW

  • Mental Health Counselor
  • Champaign, IL
National Provider Identifier
1932403797
Registry record updated Jan 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178007084 Issued in IL
Practice address
201 W Springfield Ave
Ste 1006
Champaign, IL 61820-6385
Phone
(217) 403-0790
Fax
(217) 403-0885
NPI assigned
Jan 7, 2011
Last updated
Jan 7, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178007084 IL Primary

Addresses

Primary practice location

201 W Springfield Ave
Ste 1006
Champaign, IL 61820-6385

Mailing address

705 E Lincoln St
Ste 303
Normal, IL 61761-6406
Phone (309) 451-9495

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

LicenseStateTypeSpecialty
178007084ILMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1294358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294358400000",
    "number": "1932403797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 E LINCOLN ST",
            "address_2": "STE 303",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616406",
            "telephone_number": "309-451-9495",
            "fax_number": "309-451-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W SPRINGFIELD AVE",
            "address_2": "STE 1006",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618206385",
            "telephone_number": "217-403-0790",
            "fax_number": "217-403-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEAN",
        "first_name": "TERI",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-07",
        "last_updated": "2011-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178007084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; 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.