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VICTORIA FETTER
NPI 1003439340
Counselor - Mental Health in Bloomington, IL

Active since May 21, 2020PECOS EnrolledAccepts Medicare Assignment
808 S ELDORADO RD STE 102, BLOOMINGTON, IL 61704(888) 428-7890(877) 428-7891 Get Directions Write a Review

NPPES record last updated: January 23, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 6, 2024, Apr 3, 2023, Mar 17, 2023 and 1 more (4 updates tracked since 2020).

About Victoria Fetter NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VICTORIA FETTER (NPI 1003439340) is an individual mental health provider in Bloomington, Illinois, licensed in Illinois (180015113) and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1003439340
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameVICTORIA FETTER
Location Address808 S ELDORADO RD STE 102Bloomington, IL 61704-6075
Mailing Address808 S Eldorado Rd Ste 102Bloomington, IL 61704-6075 · (888) 428-7890 · Fax (877) 428-7891
Phone(888) 428-7890
Fax(877) 428-7891
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateMay 21, 2020
Last NPPES UpdateJanuary 23, 20254 updates tracked since enumeration
NPPES CertifiedJanuary 23, 2025
✔ NPI 1003439340 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in IL · 180015113
Also ListedCounselorTaxonomy 101Y00000X · License 180.015113 (IL)
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 180015113 (IL)
808 S ELDORADO RD STE 102, Bloomington, IL 61704
Open in Google Maps ↗

Other Identifiers 1

Medicaid370915481007IL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Victoria Fetter is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1052763661
PECOS Enrollment IDI20240119000496
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Victoria Fetter reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Edgewood Clinical Services, P.C.
95 mi
Psychologist
2948 ARTESIAN RD STE 112
Naperville, IL 60564
  • Reassigned Medicare billing, Illinois enrollment
  • 475 clinicians in this Medicare group
NPI 1295914646 (630) 428-7890

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PSYCHOLOGY SPECIALISTS LTD
Psychologist (Clinical)
808 S ELDORADO RD STE 102
BLOOMINGTON, IL 61704
McLean County (888) 428-7890
JACOB P REGISTER LCSW
Social Worker (Clinical)
808 S ELDORADO RD STE 102
BLOOMINGTON, IL 61704
McLean County (309) 706-3190
ATHENA DACANAY PSYD
Psychologist (Clinical)
808 S ELDORADO RD STE 102
BLOOMINGTON, IL 61704
McLean County (309) 706-3190
ALEX BACA LPC
Counselor (Mental Health)
808 S ELDORADO RD STE 102
BLOOMINGTON, IL 61704
McLean County (888) 428-7890
MRS. JACLYN A. ORTON LCSW
Social Worker (Clinical)
808 S ELDORADO RD STE 102
BLOOMINGTON, IL 61704
McLean County (309) 706-3190
SEHAR RESHAMWALA MALINOWSKI LCPC
Counselor (Mental Health)
808 S ELDORADO RD STE 102
BLOOMINGTON, IL 61704
McLean County (888) 428-7890
SOPHIA ANNE-MARIE GAWRON LCSW
Social Worker (Clinical)
808 S ELDORADO RD STE 102
BLOOMINGTON, IL 61704
McLean County (888) 428-7890
MRS. VANESSA IRIS GRANGER-BELCHER LCPC
Counselor (Mental Health)
808 S ELDORADO RD STE 102
BLOOMINGTON, IL 61704
McLean County (309) 706-3190

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Victoria Fetter's NPI number?

The NPI number for Victoria Fetter is 1003439340. It was assigned to this individual provider in the NPPES registry on May 21, 2020.

Where is Victoria Fetter located?

Victoria Fetter practices at 808 S Eldorado Rd Ste 102, Bloomington, IL 61704. The listed phone number is (888) 428-7890.

What is Victoria Fetter's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Victoria Fetter enrolled in Medicare?

Yes. Victoria Fetter is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Victoria Fetter's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Victoria Fetter reassigns Medicare benefits to Edgewood Clinical Services, P.C. (Naperville, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Victoria Fetter's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Victoria Fetter was last updated on January 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.