KATHLEEN BACKUS MA, LCPC
NPI 1871782805
Counselor - Mental Health in Bloomington, IL

Q: What is Kathleen Backus's NPI number?

The NPI number for Kathleen Backus is 1871782805. It was assigned to this individual provider in the NPPES registry on October 16, 2007.

Q: What is Kathleen Backus's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kathleen Backus was last updated on January 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.

Active since October 16, 2007PECOS EnrolledAccepts Medicare Assignment

808 S ELDORADO RD STE 102, BLOOMINGTON, IL 61704(309) 212-6007 Get Directions Write a Review

NPPES record last updated: January 23, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Kathleen Backus Ma, Lcpc NPPES

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

KATHLEEN BACKUS MA, LCPC (NPI 1871782805) is an individual mental health provider in Bloomington, Illinois, licensed in Illinois (180004305) and active in the NPI registry since October 2007. She is enrolled in Medicare PECOS and is a graduate of Other (1998).

NPPES Registry Identity

NPI1871782805

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameKATHLEEN BACKUSCredential: MA, LCPC

Location Address808 S ELDORADO RD STE 102Bloomington, IL 61704-6075

Mailing Address2203 E Washington StBloomington, IL 61701-4322 · (309) 663-0781

Phone(309) 212-6007

Sole ProprietorYes

Medical School CMSOtherGraduated 1998

Enumeration DateOctober 16, 2007

Last NPPES UpdateJanuary 23, 2025

NPPES CertifiedJanuary 23, 2025

✔ NPI 1871782805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in IL · 180004305

Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 180004305 (IL)

808 S ELDORADO RD STE 102, Bloomington, IL 61704

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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 and accepts Medicare assignment

Kathleen Backus Ma, 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 ID7517319379

PECOS Enrollment IDI20240117001338

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 14

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

VICTORIA FETTER

Counselor (Mental Health)