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JEANINE STANDARD METAMORPHOSIS INC
NPI 1427401504
Psychologist - Clinical in Canton, IL

Active since July 13, 2016
8 S MAIN ST, SUITE 205, CANTON, IL 61520(309) 740-2171(309) 740-2171 Get Directions Write a Review

NPPES record last updated: July 13, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Jeanine Standard Metamorphosis Inc NPPES

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

JEANINE STANDARD METAMORPHOSIS INC (NPI 1427401504) is a healthcare organization registered as a clinical in Canton, Illinois and active in the NPI registry since July 2016. The organization lists Jeanine Rene Standard, Licensed Clinical Psychologist, as its authorized official.

NPPES Registry Identity

NPI1427401504
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameJEANINE STANDARD METAMORPHOSIS INC
Location Address8 S MAIN ST, SUITE 205Canton, IL 61520-2677
Mailing Address8 S Main St, Suite 205Canton, IL 61520-2677 · (309) 740-2171 · Fax (309) 740-2171
Phone(309) 740-2171
Fax(309) 740-2171
Organization SubpartNo
Authorized OfficialJeanine Rene StandardLicensed Clinical Psychologist · (309) 740-2171
Enumeration DateJuly 13, 2016
✔ NPI 1427401504 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in IL · 071.007101
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
8 S MAIN ST, Canton, IL 61520
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Other Identifiers 1

Medicare UPINK30552IL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jeanine Standard Metamorphosis Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Jeanine Standard Metamorphosis Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jeanine Standard, PH D LCPC
Clinical Psychologist
NPI 1790888311
6615 N BIG HOLLOW RD
Peoria, IL 61615
(309) 692-6622
✔ PECOS22 mi

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 Jeanine Standard Metamorphosis Inc's NPI number?

The NPI number for Jeanine Standard Metamorphosis Inc is 1427401504. It was assigned to this organization in the NPPES registry on July 13, 2016.

Where is Jeanine Standard Metamorphosis Inc located?

Jeanine Standard Metamorphosis Inc is located at 8 S Main St Suite 205, Canton, IL 61520. The listed phone number is (309) 740-2171.

What is Jeanine Standard Metamorphosis Inc's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jeanine Standard Metamorphosis Inc enrolled in Medicare?

Yes. Jeanine Standard Metamorphosis Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jeanine Standard Metamorphosis Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Jeanine Standard Metamorphosis Inc. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Jeanine Standard Metamorphosis Inc was last updated on July 13, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.