Michelle L Petty, MS, LCPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.009475 Issued in IL

Practice address

11447 2ND St
Roscoe, IL 61073-9522

Phone

(815) 979-1085

NPI assigned

Mar 20, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alternative Wellness Therapies PLLCGroup PAC ID 8628505823, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Alternative Wellness Therapies PLLC

  • Professional Counselor
  • Machesney Park, IL
  • NPI 1144802794
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1598030801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11447 2ND ST",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "610739522",
            "telephone_number": "815-979-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11447 2ND ST",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "610739522",
            "telephone_number": "815-979-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "MS, LCPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-20",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.007926",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.009475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ann Orvis, RN
• Somer Papke, M.S.
• Parris Enterprises, Inc.
• Pathway to Inner Peace, PLLC
• Bruce P. Peterson, MD
• David Nelson Piper, D.M.D.
• Positive Changes Chiropractic, LTD
• Quality Covid Control
• Courtney Rackley
• Karen L Radtke, NP

• Professional Counselor in Roscoe, IL
• Providers in Roscoe, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; 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.