Individual provider Active NPI

Roseanne Oppmann, LCPC, NCC

  • Mental Health Counselor
  • Rockford, IL
National Provider Identifier
1063622876
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.004807 Issued in IL
Practice address
5844 Elaine Dr Ste 108
Rockford, IL 61108-2494
Phone
(815) 519-3106
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180.004807 IL Primary

Addresses

Primary practice location

5844 Elaine Dr Ste 108
Rockford, IL 61108-2494

Mailing address

5844 Elaine Dr Ste 103
Rockford, IL 61108-2494
Phone (815) 519-3106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240510003082 IL Practitioner - Mental Health Counselor 1850732694 Practice locations: Rockford, IL

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5844 Elaine Dr
Suite 103
Rockford, IL 61108-2494
Phone (815) 519-3106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180.004807ILMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1063622876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5844 ELAINE DR STE 103",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082494",
            "telephone_number": "815-519-3106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5844 ELAINE DR STE 108",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082494",
            "telephone_number": "815-519-3106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPPMANN",
        "first_name": "ROSEANNE",
        "name_prefix": "Mrs.",
        "credential": "LCPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.004807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.