MS. MICHELLE DAWN TEBRUGGE (MA, LCPC, NCC) – Mental Health Counselor, NPI 1316281777

MS. MICHELLE DAWN TEBRUGGE (MA, LCPC, NCC) is a healthcare provider. based in Springfield, Illinois. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MA, LCPC, NCC. They hold a License No. 178008478 (IL). The NPI Number for MS. MICHELLE DAWN TEBRUGGE (MA, LCPC, NCC) is 1316281777

Main info

Female
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
MS. MICHELLE DAWN TEBRUGGE (MA, LCPC, NCC)
NPI
1316281777
Phone
(217) 899-0108
Address
2663 FARRAGUT DR
Enumeration Date
24 November 2012
Last Update Date
7 May 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2175443143
Graduation Year
2011 (15 years ago)
PAC ID
0840721502
Group Practice PAC ID
4082503610
Professional Enrollment ID
I20241004002138
Address ID
IL627032312SP1020XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:13State licenses:3Digital endpointsOther names

2,307 MENTAL HEALTH COUNSELOR in IL

Provider Addresses for MS. MICHELLE DAWN TEBRUGGE (MA, LCPC, NCC)

  • 2663 FARRAGUT DR

    SUITE A-5

    SPRINGFIELD, IL 627041462

    Phone: (217) 899-0108

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-10-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241004002138IMental Health CounselorILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62704)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082503610View full group profile
NameSpecialtyState
Nurse PractitionerIL
Clinical Social WorkerIL
-IL
Mental Health CounselorIL
Mental Health CounselorIL
P S Y C H I A T R YIL
Clinical Social WorkerIL
Nurse PractitionerIL

Reviews

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Frequently asked questions

How do payers reference MS. MICHELLE DAWN TEBRUGGE (MA, LCPC, NCC)?
For MS. MICHELLE DAWN TEBRUGGE (MA, LCPC, NCC), use NPI 1316281777 as the unique 10-digit identifier.
Is there an active status for MS. MICHELLE DAWN TEBRUGGE (MA, LCPC, NCC)?
For scheduling context, MS. MICHELLE DAWN TEBRUGGE (MA, LCPC, NCC) is shown as active in the registry.
How would a patient describe MS. MICHELLE DAWN TEBRUGGE (MA, LCPC, NCC)'s focus?
For MS. MICHELLE DAWN TEBRUGGE (MA, LCPC, NCC), the primary taxonomy reads as Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MS. MICHELLE DAWN TEBRUGGE (MA, LCPC, NCC)?
Travel planning: use Springfield, Illinois as the reference point for MS. MICHELLE DAWN TEBRUGGE (MA, LCPC, NCC), then confirm.
When was this NPI issued?
Enumeration for MS. MICHELLE DAWN TEBRUGGE (MA, LCPC, NCC) is noted as November 24, 2012 where the registry provides it.

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