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KEVIN SISCOE LCPC
NPI 1043632524
Counselor - Professional in Peoria, IL

Active since January 17, 2014PECOS EnrolledAccepts Medicare Assignment
6615 N BIG HOLLOW RD, PEORIA, IL 61615(309) 692-6622(309) 692-6952 Get Directions Write a Review

NPPES record last updated: October 3, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kevin Siscoe Lcpc NPPES

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

KEVIN SISCOE LCPC (NPI 1043632524) is an individual professional provider in Peoria, Illinois, licensed in Illinois (180008974) and active in the NPI registry since January 2014. He is enrolled in Medicare PECOS and is a graduate of Other (2010).

NPPES Registry Identity

NPI1043632524
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameKEVIN SISCOECredential: LCPC
Location Address6615 N BIG HOLLOW RDPeoria, IL 61615-2450
Mailing Address6615 N Big Hollow RdPeoria, IL 61615-2450 · (309) 692-6622 · Fax (309) 692-6952
Phone(309) 692-6622
Fax(309) 692-6952
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateJanuary 17, 2014
Last NPPES UpdateOctober 3, 2024
NPPES CertifiedOctober 3, 2024
✔ NPI 1043632524 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in IL · 180008974
6615 N BIG HOLLOW RD, Peoria, IL 61615
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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

Kevin Siscoe Lcpc 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 ID6204287279
PECOS Enrollment IDI20240104001251
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 Kevin Siscoe reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

The Antioch Group, Inc.
Same address
Psychologist
6615 N. BIG HOLLOW RD.
Peoria, IL 61615
  • Reassigned Medicare billing, Illinois enrollment
  • 12 clinicians in this Medicare group
NPI 1801993142 (309) 692-6622

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

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 45 minutes 90834
Psychotherapy is a treatment method where you converse with a therapist about your thoughts, feelings, and behaviors. In a 45-minute session, the therapist assists you in understanding and managing your mental health concerns, improving emotional wellness, and promoting personal growth.
66 services16 patients
Psychiatric diagnostic evaluation 90791
A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.
16 services16 patients

Other Providers at the Same Location NPPES 20

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

MRS. MICHELLE SUE BAKER LCPC CADC
Counselor
6615 N BIG HOLLOW RD
PEORIA, IL 61615
Peoria County (309) 692-6622
STEPHANIE SEIDL MA
Counselor (Mental Health)
6615 N BIG HOLLOW RD
PEORIA, IL 61615
Peoria County (309) 692-6622
MICHELLE QUINN
Counselor (Mental Health)
6615 N BIG HOLLOW RD
PEORIA, IL 61615
Peoria County (309) 692-6622
MS. DONNA SUE WASSON M.A., L.C.P.C., NCC
Counselor (Professional)
6615 N BIG HOLLOW RD
PEORIA, IL 61615
Peoria County (309) 692-6622
CLAIRE LEECH
Counselor (Mental Health)
6615 N BIG HOLLOW RD
PEORIA, IL 61615
Peoria County (309) 692-6622
TIFFANY JORDAN LCPC
Counselor
6615 N BIG HOLLOW RD
PEORIA, IL 61615
Peoria County (309) 692-6622
STEVEN ALLEN HAMON PHD
Psychologist
6615 N BIG HOLLOW RD
PEORIA, IL 61615
Peoria County (309) 692-6622
DR. RUDOLF G BREITMEYER PHD
Psychologist
6615 N BIG HOLLOW RD
PEORIA, IL 61615
Peoria County (309) 692-6622

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 Kevin Siscoe's NPI number?

The NPI number for Kevin Siscoe is 1043632524. It was assigned to this individual provider in the NPPES registry on January 17, 2014.

Where is Kevin Siscoe located?

Kevin Siscoe practices at 6615 N Big Hollow Rd, Peoria, IL 61615. The listed phone number is (309) 692-6622.

What is Kevin Siscoe's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Kevin Siscoe enrolled in Medicare?

Yes. Kevin Siscoe 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 Kevin Siscoe's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Siscoe reassigns Medicare benefits to The Antioch Group, Inc. (Peoria, 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 Kevin Siscoe'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 Kevin Siscoe was last updated on October 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.