Individual provider Active NPI

Alexa Nutt

  • Counselor
  • Champaign, IL
National Provider Identifier
1467038257
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
178-016699 Issued in IL
Practice address
309 W Clark St
Champaign, IL 61820-4637
Phone
(217) 398-9066
Fax
(217) 398-9077
NPI assigned
Mar 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 178-016699 IL Primary

Addresses

Primary practice location

309 W Clark St
Champaign, IL 61820-4637

Mailing address

309 W Clark St
Champaign, IL 61820-4637
Phone (217) 398-9066

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
I20250307003365 IL Practitioner - Mental Health Counselor 3072034909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rodney J. Benson, PHD and Associates, LLCGroup PAC ID 1052435419, 8 clinicians

Practice addresses (Care Compare)

3047 N Lincoln Ave
Unit 400
Chicago, IL 60657-4274
Phone (773) 494-5055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178-016699ILMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rodney J. Benson, PHD & Associates, LLC CurrentSince Jan 13, 2025 Accepting new patients

Locations

3047 N Lincoln Ave
Unit 400
Chicago, IL 60657
Phone (773) 494-5055

3047 N Lincoln Ave
Chicago, IL 60657
Phone (773) 494-5505

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.

NPI Registry JSON

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1467038257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 W CLARK ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618204637",
            "telephone_number": "217-398-9066",
            "fax_number": "217-389-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 W CLARK ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618204637",
            "telephone_number": "217-398-9066",
            "fax_number": "217-398-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTT",
        "first_name": "ALEXA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2023-03-28",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178-016699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.