Susan D Allen, MS LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180005692 Issued in IL

Practice address

8051 Old River Rd
Rockford, IL 61103-8735

Phone

(815) 608-1205

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Crusaders Central Clinic Association

  • Federally Qualified Health Center (FQHC)
  • Rockford, IL
  • NPI 1902972557
  NPD (past)

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

• Susan D Penney Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 26, 2018.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522022400000",
    "number": "1104936749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8051 OLD RIVER RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611038735",
            "telephone_number": "815-608-1205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8051 OLD RIVER RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611038735",
            "telephone_number": "815-608-1205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "SUSAN",
        "middle_name": "D",
        "credential": "MS LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2018-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180005692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "10132177",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "PENNEY",
            "middle_name": "D",
            "credential": "MS LCPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Benjamin Allen
• Cameron Allen, DO
• Jeffrey Paul Allen, DDS
• Rick W Allen, C.O.
• Ronald Allen, RPH
• Arlyn O Alley, LPT
• Allison Benthal D.O. S.C.
• Allison Bozovsky, LMFT, LLC
• Laura Lynn Allman, LCSW
• Along the Path Counseling Services P.C.

• All providers in Rockford, IL
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.