Individual provider Active NPI

Carol D Trejo Kroeger, LCPC

  • Mental Health Counselor
  • Crystal Lake, IL
National Provider Identifier
1962823542
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.011220 Issued in IL
Practice address
1095 Pingree Rd Ste 202
Crystal Lake, IL 60014
Phone
(224) 456-9356
NPI assigned
Dec 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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 180.011220 IL Primary

Addresses

Primary practice location

1095 Pingree Rd Ste 202
Crystal Lake, IL 60014

Mailing address

1095 Pingree Rd Ste 202
Crystal Lake, IL 60014-1727
Phone (224) 456-9356

Other practice location 1

215 N Main St
Algonquin, IL 60102-2448
Phone (224) 678-9033

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
180.011220ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Post Acute Care PLLC Past Accepting new patients
Lakeview Counseling Services Mental Health PastSince Apr 17, 2019 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1388016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1962823542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 PINGREE RD STE 202",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600141727",
            "telephone_number": "224-456-9356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 PINGREE RD STE 202",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014",
            "telephone_number": "224-456-9356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 N Main St",
            "address_purpose": "LOCATION",
            "city": "Algonquin",
            "state": "IL",
            "postal_code": "601022448",
            "country_code": "US",
            "telephone_number": "224-678-9033",
            "fax_number": "224-678-9493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TREJO KROEGER",
        "first_name": "CAROL",
        "middle_name": "D",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-26",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.011220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; 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.