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MARY HOSBROUGH LCPC
NPI 1700402211
Counselor - Professional in Peoria, IL

Active since June 20, 2020Opted out of Medicare · through Jul 22, 2028
1200 HAMILTON BLVD, PEORIA, IL 61606(309) 671-8040 Get Directions Write a Review

NPPES record last updated: June 20, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mary Hosbrough Lcpc NPPES

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

MARY HOSBROUGH LCPC (NPI 1700402211) is an individual professional provider in Peoria, Illinois, licensed in Illinois (180011543) and active in the NPI registry since June 2020. She has opted out of Medicare through July 22, 2028.

NPPES Registry Identity

NPI1700402211
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMARY HOSBROUGHCredential: LCPC
Location Address1200 HAMILTON BLVDPeoria, IL 61606-1525
Mailing Address1200 Hamilton BlvdPeoria, IL 61606-1525 · (309) 671-8040
Phone(309) 671-8040
Sole ProprietorNo
Enumeration DateJune 20, 2020
NPPES CertifiedJune 20, 2020
✔ NPI 1700402211 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 · 180011543
1200 HAMILTON BLVD, Peoria, IL 61606
Open in Google Maps ↗

Other Identifiers 1

Other180011543IL · License

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mary Hosbrough Lcpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 22, 2026 through July 22, 2028.

Opt-Out Effective DateJuly 22, 2026
Opt-Out In Effect ThroughJuly 22, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 9

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

HUMAN SERVICE CENTER
Clinic/Center (Rehabilitation, Substance Use Disorder)
1200 HAMILTON BLVD
PEORIA, IL 61606
Peoria County (309) 671-8005
SHAWN DOUD QMHP
Counselor
1200 HAMILTON BLVD
PEORIA, IL 61606
Peoria County (309) 671-8043
HUMAN SERVICE CENTER
Clinic/Center (Mental Health (Including Community Mental Health Center))
1200 HAMILTON BLVD
PEORIA, IL 61606
Peoria County (309) 671-8005
GARY ANDERSON M.A.
Counselor (Mental Health)
1200 HAMILTON BLVD
PEORIA, IL 61606
Peoria County (309) 637-1696
TAHARI NICOLE ALLEN LCPC
Counselor (Professional)
1200 HAMILTON BLVD
PEORIA, IL 61606
Peoria County (309) 671-8040
JALISA SMITH-JORDAN LCSW
Social Worker (Clinical)
1200 HAMILTON BLVD
PEORIA, IL 61606
Peoria County (309) 671-8040
DEBORAH OBERG M.S., L.P.C.
Counselor (Professional)
1200 HAMILTON BLVD
PEORIA, IL 61606
Peoria County (309) 671-8054
TERA BOETTCHER MSW
Counselor (Mental Health)
1200 HAMILTON BLVD
PEORIA, IL 61606
Peoria County (309) 637-1695

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 Mary Hosbrough's NPI number?

The NPI number for Mary Hosbrough is 1700402211. It was assigned to this individual provider in the NPPES registry on June 20, 2020.

Where is Mary Hosbrough located?

Mary Hosbrough practices at 1200 Hamilton Blvd, Peoria, IL 61606. The listed phone number is (309) 671-8040.

What is Mary Hosbrough's specialty?

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

Is Mary Hosbrough enrolled in Medicare?

No. Mary Hosbrough has opted out of Medicare through July 22, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Mary Hosbrough was last updated on June 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.