DR. JEANINE R STANDARD (PH D LCPC) – Psychologist, NPI 1790888311

DR. JEANINE R STANDARD (PH D LCPC) is a healthcare provider. based in Peoria, Illinois. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH D LCPC. The NPI Number for DR. JEANINE R STANDARD (PH D LCPC) is 1790888311

Main info

Female
23 Years Of Experience
Name
DR. JEANINE R STANDARD (PH D LCPC)
NPI
1790888311
Phone
(309) 692-6622
Address
6615 N BIG HOLLOW RD
Enumeration Date
7 September 2006
Last Update Date
2 December 2009

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3097402171802
Graduation Year
2003 (23 years ago)
PAC ID
4587660394
Professional Enrollment ID
I20061018000059
Address ID
IL615208708CA17291LNXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:19State licenses:0Digital endpointsOther names

1,600 CLINICAL PSYCHOLOGIST in IL

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Provider Addresses for DR. JEANINE R STANDARD (PH D LCPC)

  • Big Hollow Professional, 6615, North Big Hollow Road, Peoria, Peoria County, Illinois, 61615, United States

    PEORIA, IL 616152451

    Phone: (309) 692-6622

    Fax: (309) 692-6952

    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: 2006-10-18

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
I20061018000059IClinical PsychologistILTBD

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 61615)

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Reviews

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Frequently asked questions

Can I verify DR. JEANINE R STANDARD (PH D LCPC) with an NPI only?
You can start verification with NPI 1790888311 for DR. JEANINE R STANDARD (PH D LCPC), then check state licensing separately.
Can I rely on DR. JEANINE R STANDARD (PH D LCPC) being an active provider?
As of the registry snapshot, DR. JEANINE R STANDARD (PH D LCPC) is marked active.
What taxonomy line describes DR. JEANINE R STANDARD (PH D LCPC)?
For research purposes, treat DR. JEANINE R STANDARD (PH D LCPC) as Psychologist in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect DR. JEANINE R STANDARD (PH D LCPC) on a map?
Expect Peoria, Illinois as a primary anchor for DR. JEANINE R STANDARD (PH D LCPC) unless the record lists multiple sites.
Is the information about DR. JEANINE R STANDARD (PH D LCPC) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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