1. Home
  2. Directory
  3. Illinois
  4. Urbana
  5. Counselor
  6. NPI Profile

WANDA RAQUEL ORTIZ HERNANDEZ LCPC
NPI 1104506393
Counselor - Professional in Urbana, IL

Active since July 21, 2023PECOS EnrolledAccepts Medicare Assignment
2001 PHILO RD, URBANA, IL 61802(217) 552-1211 Get Directions Write a Review

NPPES record last updated: July 21, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Wanda Raquel Ortiz Hernandez Lcpc NPPES

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

WANDA RAQUEL ORTIZ HERNANDEZ LCPC (NPI 1104506393) is an individual professional provider in Urbana, Illinois, licensed in Illinois (180.015451) and active in the NPI registry since July 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1104506393
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameWANDA RAQUEL ORTIZ HERNANDEZCredential: LCPC
Location Address2001 PHILO RDUrbana, IL 61802-8007
Mailing Address309 W Clark StChampaign, IL 61820-4637 · (217) 398-9066
Phone(217) 552-1211
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJuly 21, 2023
NPPES CertifiedJuly 21, 2023
✔ NPI 1104506393 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 · 180.015451
2001 PHILO RD, Urbana, IL 61802
Open in Google Maps ↗

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

Wanda Raquel Ortiz Hernandez 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 ID1153769534
PECOS Enrollment IDI20240404001055
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 Wanda Ortiz Hernandez reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kevin Elliott Counseling PC
Same address
Mental Health
2001 PHILO RD
Urbana, IL 61802
  • Reassigned Medicare billing, Illinois enrollment
  • 25 clinicians in this Medicare group
NPI 1255357422 (217) 398-9066

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 16

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

COURTNEY LEIGH PRATHER
Social Worker (Clinical)
2001 PHILO RD
URBANA, IL 61802
Champaign County (217) 552-1211
MEGAN WITOWSKI CNM, PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
2001 PHILO RD
URBANA, IL 61802
Champaign County (217) 398-9066
STEPHANIE WILLIAMSON LPC
Counselor (Professional)
2001 PHILO RD
URBANA, IL 61802
Champaign County (217) 638-1195
ATIYYA N THOMPSON LPC
Counselor (Professional)
2001 PHILO RD
URBANA, IL 61802
Champaign County (217) 398-9066
KEVIN ELLIOTT COUNSELING PC
Counselor (Mental Health)
2001 PHILO RD
URBANA, IL 61802
Champaign County (217) 398-9066
BRANDY NICOLE THOMPSON LPC
Counselor (Professional)
2001 PHILO RD
URBANA, IL 61802
Champaign County (217) 398-9066
ALEXIS SAMANTHA GATSES LCSW
Social Worker (Clinical)
2001 PHILO RD
URBANA, IL 61802
Champaign County (217) 398-9066
MICHAEL QUINN MCCULLEY LSW
Social Worker (Clinical)
2001 PHILO RD
URBANA, IL 61802
Champaign County (217) 398-9066

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 Wanda Ortiz Hernandez's NPI number?

The NPI number for Wanda Ortiz Hernandez is 1104506393. It was assigned to this individual provider in the NPPES registry on July 21, 2023.

Where is Wanda Ortiz Hernandez located?

Wanda Ortiz Hernandez practices at 2001 Philo Rd, Urbana, IL 61802. The listed phone number is (217) 552-1211.

What is Wanda Ortiz Hernandez's specialty?

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

Is Wanda Ortiz Hernandez enrolled in Medicare?

Yes. Wanda Ortiz Hernandez 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 Wanda Ortiz Hernandez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Wanda Ortiz Hernandez reassigns Medicare benefits to Kevin Elliott Counseling PC (Urbana, 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 Wanda Ortiz Hernandez'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 Wanda Ortiz Hernandez was last updated on July 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.