Individual provider Active NPI

Rich G Magsombol

  • Mental Health Counselor
  • Arlington Heights, IL
National Provider Identifier
1528667797
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178.006727 Issued in IL
Practice address
1835 W Central Rd
Arlington Heights, IL 60005-2410
Phone
(847) 870-2636
NPI assigned
Oct 20, 2020
Last updated
Oct 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178.006727 IL Primary

Addresses

Primary practice location

1835 W Central Rd
Arlington Heights, IL 60005-2410

Mailing address

4221 N Pheasant Trail CT Unit 6
Arlington Heights, IL 60004-7996
Phone (847) 924-4111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20240215000692 NE Practitioner - Mental Health Counselor 3072957331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centerpointe IncGroup PAC ID 8123063237, 11 clinicians

Practice addresses (Care Compare)

2202 S 11TH St
Lincoln, NE 68502-3559
Phone (402) 475-5161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178.006727ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Centerpointe, Inc. Mental Health CurrentSince Jan 10, 2024 Accepting new patients

Locations

2202 S 11th St
Lincoln, NE 68502
Phone (402) 475-5161

2633 P St
Lincoln, NE 68503
Phone (402) 475-5161

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1528667797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 N PHEASANT TRAIL CT UNIT 6",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600047996",
            "telephone_number": "847-924-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 W CENTRAL RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052410",
            "telephone_number": "847-870-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGSOMBOL",
        "first_name": "RICH",
        "middle_name": "G",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.006727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.