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MS. THERESA ANN KENNEDY PATTON LCPC CRC LPC LCAC
NPI 1114210721
Counselor - Mental Health in Washington, IL

Active since May 16, 2011PECOS EnrolledAccepts Medicare Assignment
617 STEPHANIE CT, WASHINGTON, IL 61571(317) 799-4343(317) 643-8989 Get Directions Write a Review

NPPES record last updated: June 25, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 1, 2025, Feb 21, 2025, Jul 16, 2024 and 3 more (6 updates tracked since 2019).

About Ms. Theresa Ann Kennedy Patton Lcpc Crc Lpc Lcac NPPES

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

MS. THERESA ANN KENNEDY PATTON LCPC CRC LPC LCAC (NPI 1114210721) is an individual mental health provider in Washington, Illinois, licensed in Illinois (180015238) and active in the NPI registry since May 2011. She is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1114210721
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMS. THERESA ANN KENNEDY PATTONCredential: LCPC CRC LPC LCAC
Location Address617 STEPHANIE CTWashington, IL 61571-9279
Mailing Address617 Stephanie CtWashington, IL 61571-9279 · (317) 799-4343 · Fax (317) 643-8989
Phone(317) 799-4343
Fax(317) 643-8989
Sole ProprietorYes
Medical School CMSOtherGraduated 2006
Enumeration DateMay 16, 2011
Last NPPES UpdateJune 25, 20266 updates tracked since enumeration
NPPES CertifiedJune 25, 2026
✔ NPI 1114210721 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Licenses✔ Licensed in IL · 180015238✔ Licensed in MO · 2025015218✔ Licensed in WI · 11965125✔ Licensed in AZ · 23605
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 16405 (TX), 15216 (AZ), 87001357A (IN), 1804 (NC)
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 23605 (AZ)
Also ListedRehabilitation CounselorTaxonomy 225C00000X · License 204377 (IL)
617 STEPHANIE CT, Washington, IL 61571
Open in Google Maps ↗

Other Identifiers 2

Medicaid1114210721IL
Other1114210721IL · Blue Cross Blue Shield

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Cigna Healthcare, UnitedHealthcare.Insurance ›

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

Ms. Theresa Ann Kennedy Patton Lcpc Crc Lpc Lcac 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 ID6305102112
PECOS Enrollment IDI20240604003330
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 Theresa Kennedy Patton reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Brightside Medical, P.A.
1,772 mi
Psychiatry
5214F DIAMOND HEIGHTS BLVD # 345
San Francisco, CA 94131
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Brightside Medical PA
  • 50 clinicians in this Medicare group
NPI 1609335660 (415) 360-3348

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

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 Theresa Kennedy Patton's NPI number?

The NPI number for Theresa Kennedy Patton is 1114210721. It was assigned to this individual provider in the NPPES registry on May 16, 2011.

Where is Theresa Kennedy Patton located?

Theresa Kennedy Patton practices at 617 Stephanie Ct, Washington, IL 61571. The listed phone number is (317) 799-4343.

What is Theresa Kennedy Patton's specialty?

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

Is Theresa Kennedy Patton enrolled in Medicare?

Yes. Theresa Kennedy Patton 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 Theresa Kennedy Patton's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Theresa Kennedy Patton reassigns Medicare benefits to Brightside Medical, P.A. (San Francisco, CA). 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 Theresa Kennedy Patton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Theresa Kennedy Patton accept?

Health plans from Anthem Blue Cross and Blue Shield, Cigna Healthcare and UnitedHealthcare list Theresa Kennedy Patton as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Theresa Kennedy Patton was last updated on June 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.