Individual provider Active NPI

Anita Ann Thomas Bua, LCPC,LPC

  • Mental Health Counselor
  • Rockford, IL
National Provider Identifier
1457499022
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180008157 Issued in IL
Practice address
1639 N Alpine Rd Ste 260
Rockford, IL 61107-1481
Phone
(815) 395-1500
Fax
(833) 656-2718
NPI assigned
Feb 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178004743 IL
Professional Counselor 101YP2500X 3755-125 WI
Mental Health Counselor 101YM0800X 180008157 IL Primary

Addresses

Primary practice location

1639 N Alpine Rd Ste 260
Rockford, IL 61107-1481

Mailing address

1639 N Alpine Rd Ste 260
Rockford, IL 61107-1481
Phone (815) 395-1500

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
I20260109002578 IL Practitioner - Mental Health Counselor 6103261235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crusaders Central Clinic AssociationGroup PAC ID 5799682993, shared by 7 NPIs, 31 clinicians

Practice addresses (Care Compare)

1215 N Alpine Rd
Rockford, IL 61107-2201
Phone (815) 490-1600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178004743ILMDProfessional Counselor
3755-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Psychiatric Medical Services, S.C. CurrentSince Jan 19, 2022 Accepting new patients
Crusaders Central Clinic Association Past Accepting new patients
Crusaders Central Clinic Association Past Accepting new patients

Locations

1639 N Alpine Rd
Ste 260
Rockford, IL 61107
Phone (815) 395-1500

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": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1457499022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1639 N ALPINE RD STE 260",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071481",
            "telephone_number": "815-395-1500",
            "fax_number": "833-656-2718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1639 N ALPINE RD STE 260",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071481",
            "telephone_number": "815-395-1500",
            "fax_number": "833-656-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS BUA",
        "first_name": "ANITA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCPC,LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-03",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178004743",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3755-125",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180008157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.