Active NPI
Annette McLean, LCPC
- Mental Health Counselor
- Rockford, IL
National Provider Identifier
1396767257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 180-002290
- Practice address
- 5301 East State St
Ste 202
Rockford, IL 61108 - Phone
- (815) 289-5464
- Fax
- (779) 368-0378
- NPI assigned
- Jul 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 180-002290 | IL | Primary |
Addresses
Primary practice location
5301 East State St
Ste 202
Rockford, IL 61108
Mailing address
4931 Dellview Dr
Rockford, IL 61109
Phone (815) 289-5464
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180-002290 | IL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Mental Health | Current | Accepting new patients |
Interoperability endpoints
- annettemclean@tdh.allscriptsdirect.net
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Lewisville, TX
- NPI 1245403567
Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393545600000",
"number": "1396767257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4931 DELLVIEW DR",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "61109",
"telephone_number": "815-289-5464",
"fax_number": "779-368-0378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5301 EAST STATE ST",
"address_2": "STE 202",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "61108",
"telephone_number": "815-289-5464",
"fax_number": "779-368-0378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCLEAN",
"first_name": "ANNETTE",
"name_prefix": "Ms.",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-23",
"last_updated": "2014-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "180-002290",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.