Shannon M Nelson, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180017209 Issued in IL

Practice address

1639 N Alpine Rd Ste Rockford
Rockford, IL 61107-1449

Phone

(815) 200-8277

NPI assigned

Jan 15, 2013

Last updated

Mar 10, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rockford Psychiatric Medical Services SCGroup PAC ID 6901089515, 154 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Rockford Psychiatric Medical Services, S.C.

  • Psychiatry Physician
  • Rockford, IL
  • NPI 1821391442
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1358208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1528305174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 HIGHCREST RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1639 N ALPINE RD STE ROCKFORD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071449",
            "telephone_number": "815-200-8277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SHANNON",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-15",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180017209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Ray Nelson, LPTA
• Jonathan Scott Nelson, LCPC
• Michelle Nelson
• Miranda M Nelson
• Sara Nelson
• Nephrology Associates of Northern Illinois LTD
• Christopher J Nesmith, PA-C
• Network Medical Review Company LTD (Elite Physicians)
• Rebekha Neu, MD
• Bradley Edward Neukirch, RPH

• Mental Health Counselor in Rockford, IL
• Providers in Rockford, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.