Erin M Bergren, MS.ED., LCPC, ACS
Individual provider Active NPI Mental Health Counselor · Roscoe, IL
NPI 1215609797 · NPPES record last updated Feb 23, 2022
Key facts
- NPI
- 1215609797
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 180.010642 (IL)
- Practice address
- 5290 Williams Dr
Roscoe, IL 61073-9222 - Phone
- (262) 607-1234
- NPI assigned
- Oct 1, 2021
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180.010642 | IL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kathleen E Cox PC | Professional | Current |
Accepting new patients |
Locations
5290 Williams Dr
Roscoe, IL 61073
Phone (815) 324-0324
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor |
101YP2500X | |||
| Mental Health Counselor | 101YM0800X | 180.010642 | IL | Yes |
Addresses
Primary practice location
5290 Williams Dr
Roscoe, IL 61073-9222
Mailing address
229 Martin St
Sharon, WI 53585-9617
Phone (102) 626-0712
Other providers in Roscoe, IL
- Beloit Health System Inc
- Beloit Health System Inc
- Beloit Health System, Inc
- Marek S Bentkowski
- Melissa Berg
- Sreeka Bharani
- Ankit Bhargava
- Kathryn E Bjerke
- Blackman Chiropractic PC
- Sarah Elizabeth Blatchford
All providers in Roscoe, IL · Mental Health Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.