Individual provider Active NPI

Alicia Severins, LCPC

  • Mental Health Counselor
  • Champaign, IL
National Provider Identifier
1124588900
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180003308 Issued in IL
Practice address
3362 Big Pine TRL Ste a
Champaign, IL 61822-1409
Phone
(217) 383-0151
Fax
(217) 633-4555
NPI assigned
Mar 20, 2019
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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 180003308 IL
Mental Health Counselor 101YM0800X 180003308 IL Primary

Addresses

Primary practice location

3362 Big Pine TRL Ste a
Champaign, IL 61822-1409

Mailing address

3362 Big Pine TRL Ste a
Champaign, IL 61822-1409
Phone (217) 383-0151

Other names 1

  • Alicia Mangrum-Nuss Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Therapy PastSince Mar 11, 2013 Accepting new patients
Dulski Counseling, LLC Mental Health PastSince Sep 21, 2025 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1124588900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3362 BIG PINE TRL STE A",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221409",
            "telephone_number": "217-383-0151",
            "fax_number": "217-633-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3362 BIG PINE TRL STE A",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221409",
            "telephone_number": "217-383-0151",
            "fax_number": "217-633-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERINS",
        "first_name": "ALICIA",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180003308",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180003308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "MANGRUM-NUSS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.