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KATIE NEIDETCHER LCPC
NPI 1093376329
Counselor - Professional in Peoria, IL

Active since June 26, 2019PECOS Enrolled
7210 N VILLA LAKE DR STE C, PEORIA, IL 61614(309) 713-1485(309) 419-4328 Get Directions Write a Review

NPPES record last updated: June 26, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Katie Neidetcher Lcpc NPPES

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

KATIE NEIDETCHER LCPC (NPI 1093376329) is an individual professional provider in Peoria, Illinois, licensed in Illinois (180011916) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1093376329
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameKATIE NEIDETCHERCredential: LCPC
Location Address7210 N VILLA LAKE DR STE CPeoria, IL 61614-8290
Mailing AddressPo Box 10286Peoria, IL 61612-0286 · (309) 713-1485 · Fax (309) 419-4328
Phone(309) 713-1485
Fax(309) 419-4328
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJune 26, 2019
✔ NPI 1093376329 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 · 180011916
7210 N VILLA LAKE DR STE C, Peoria, IL 61614
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Katie Neidetcher Lcpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6406328749
PECOS Enrollment IDI20260623003245
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.

Other Providers at the Same Location NPPES 10

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

MICHELLE MATZKE MA, LCPC
Counselor (Mental Health)
7210 N VILLA LAKE DR STE C
PEORIA, IL 61614
Peoria County (309) 713-1485
JULIENNE A CUMMINGS LCSW, RN
Social Worker (Clinical)
7210 N VILLA LAKE DR STE C
PEORIA, IL 61614
Peoria County (309) 713-1485
GRETA LONG
Counselor (Professional)
7210 N VILLA LAKE DR STE C
PEORIA, IL 61614
Peoria County (309) 798-4962
MRS. RACHEL VICTORIA LAMPE MA, LPC
Counselor
7210 N VILLA LAKE DR STE C
PEORIA, IL 61614
Peoria County (309) 713-1485
HANNAH DOBSON MA,AMFT, QMHP
Marriage & Family Therapist
7210 N VILLA LAKE DR STE C
PEORIA, IL 61614
Peoria County (309) 713-1485
SHELLY HART MA, LCP
Counselor (Mental Health)
7210 N VILLA LAKE DR STE C
PEORIA, IL 61614
Peoria County (309) 713-1485
SUMMIT FAMILY THERAPY PLLC
Counselor (Professional)
7210 N VILLA LAKE DR STE C
PEORIA, IL 61614
Peoria County (309) 713-1485
KATELYN MILLS LPC
Counselor (Professional)
7210 N VILLA LAKE DR STE C
PEORIA, IL 61614
Peoria County (309) 713-1485

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 Katie Neidetcher's NPI number?

The NPI number for Katie Neidetcher is 1093376329. It was assigned to this individual provider in the NPPES registry on June 26, 2019.

Where is Katie Neidetcher located?

Katie Neidetcher practices at 7210 N Villa Lake Dr Ste C, Peoria, IL 61614. The listed phone number is (309) 713-1485.

What is Katie Neidetcher's specialty?

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

Is Katie Neidetcher enrolled in Medicare?

Yes. Katie Neidetcher is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Katie Neidetcher was last updated on June 26, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.