MISS KATHY JO CORN (MA, LCPC) – Mental Health Counselor, NPI 1689769119

MISS KATHY JO CORN (MA, LCPC) is a healthcare provider. based in Belleville, Illinois. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MA, LCPC. They hold a License No. 180-00091 (IL). The NPI Number for MISS KATHY JO CORN (MA, LCPC) is 1689769119

Main info

Female
42 Years Of Experience
Accepts Medicare Assignment
Name
MISS KATHY JO CORN (MA, LCPC)
NPI
1689769119
Phone
(618) 825-0051
Address
521 W. MAIN, SUITE 201 B
Enumeration Date
3 October 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6188250051
Graduation Year
1984 (42 years ago)
PAC ID
4880035666
Group Practice PAC ID
3173428638
Professional Enrollment ID
I20240510000734
Address ID
IL622081340FA331XXPLXX302
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,308 MENTAL HEALTH COUNSELOR in IL

Provider Addresses for MISS KATHY JO CORN (MA, LCPC)

  • 521 W. MAIN, SUITE 201 B

    BELLEVILLE, IL 62220

    Phone: (618) 825-0051

    Fax: (618) 825-0051

    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: 2024-05-10

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
I20240510000734IMental 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 62220)

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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: 3173428638View full group profile
NameSpecialtyState
Nurse PractitionerMO
Clinical PsychologistMO
Clinical Social WorkerMO
Clinical PsychologistSC
-MO
P S Y C H I A T R YMO
Clinical PsychologistMO
Clinical Social WorkerMO
-MO
Clinical Social WorkerMO

Reviews

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Frequently asked questions

What is the standard ID for MISS KATHY JO CORN (MA, LCPC) in the U.S.?
In the U.S., MISS KATHY JO CORN (MA, LCPC) is identified by NPI 1689769119.
Quick check: is MISS KATHY JO CORN (MA, LCPC) active?
Public NPPES data shows MISS KATHY JO CORN (MA, LCPC) with an active NPI status right now.
What type of care does MISS KATHY JO CORN (MA, LCPC) provide?
MISS KATHY JO CORN (MA, LCPC)'s profile centers on Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Which community is linked to MISS KATHY JO CORN (MA, LCPC)?
MISS KATHY JO CORN (MA, LCPC) shows a connection to Belleville, Illinois in registry-derived data.
Who maintains MISS KATHY JO CORN (MA, LCPC)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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