Individual provider Active NPI

Alexandra Kane, M.S., L.P.C

  • Professional Counselor
  • Crystal Lake, IL
National Provider Identifier
1124418314
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180010506 Issued in IL
Practice address
620 Dakota St
Crystal Lake, IL 60012-3732
Phone
(815) 276-0557
NPI assigned
Jan 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178.009790 IL
Professional Counselor 101YP2500X 180010506 IL Primary

Addresses

Primary practice location

620 Dakota St
Crystal Lake, IL 60012-3732

Mailing address

620 Dakota St
Crystal Lake, IL 60012-3732
Phone (815) 276-0557

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
I20240117004335 IL Practitioner - Mental Health Counselor 8224480074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rosecrance IncGroup PAC ID 3779656582, 33 clinicians

Practice addresses (Care Compare)

1601 N University Dr
Rockford, IL 61107-5317
Phone (815) 387-2500

620 Dakota St
FL 1
Crystal Lake, IL 60012-3732
Phone (815) 391-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
178.009790ILMDProfessional Counselor
180010506ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rosecrance Inc. CurrentSince Jan 1, 2024 Accepting new patients
Rosecrance Inc CurrentSince Jan 1, 2024 Accepting new patients
Rosecrance Inc Current Accepting new patients

Locations

1601 University Dr
Rockford, IL 61107
Phone (815) 387-2500

1021 N Mulford Rd
Rockford, IL 61107
Phone (815) 387-5600

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1422316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1124418314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 DAKOTA ST",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600123732",
            "telephone_number": "815-276-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 DAKOTA ST",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600123732",
            "telephone_number": "815-276-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANE",
        "first_name": "ALEXANDRA",
        "name_prefix": "Mrs.",
        "credential": "M.S., L.P.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-27",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.009790",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180010506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.