Individual provider Active NPI

Scott F Terry, ED.D., LMFT, LCPC

  • Marriage & Family Therapist
  • Streamwood, IL
National Provider Identifier
1629133905
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
166.000736 Issued in IL
Practice address
684 S Barrington Rd
Ste 112
Streamwood, IL 60107-1841
Phone
(641) 233-8273
Fax
(847) 349-1619
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180.006449 IL
Marriage & Family Therapist 106H00000X 166.000736 IL Primary

Addresses

Primary practice location

684 S Barrington Rd
Ste 112
Streamwood, IL 60107-1841

Mailing address

684 S Barrington Rd
Ste 112
Streamwood, IL 60107-1841
Phone (641) 233-8273

Other identifiers 1

IdentifierTypeStateIssuer
180.006449OtherILLCPC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20231220000571 IA Practitioner - Mental Health Counselor 3274618400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
May accept Medicare assignment
Group practices
Rodasi LLCGroup PAC ID 0749418630, 34 clinicians

Practice addresses (Care Compare)

306 W State St
Williamsburg
Williamsburg, IA 52361-9700
Phone (319) 668-1217

500 N 3Rd St
Suite 209
Fairfield, IA 52556-2483
Phone (888) 870-1775

818 4TH Ave
Grinnell, IA 50112-2041
Phone (641) 236-1644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180.006449ILMDMental Health Counselor
166.000736ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rodasi LLC Mental Health CurrentSince Jan 12, 2009 Accepting new patients

Locations

500 N 3rd St
Ste 209
Fairfield, IA 52556

818 4th Ave
Grinnell, IA 50112
Phone (641) 236-1644

2500 W Higgins Rd
Ste 105
Hoffman Estates, IL 60169
Phone (773) 904-0094

684 S Barrington Rd
Streamwood, IL 60107
Phone (630) 883-0815

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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1629133905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "684 S BARRINGTON RD",
            "address_2": "STE 112",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601071841",
            "telephone_number": "641-233-8273",
            "fax_number": "847-349-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "684 S BARRINGTON RD",
            "address_2": "STE 112",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601071841",
            "telephone_number": "641-233-8273",
            "fax_number": "847-349-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "SCOTT",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "ED.D., LMFT, LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.006449",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.000736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCPC",
            "identifier": "180.006449",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Streamwood, IL

Sources for this page

Verify at the official NPI Registry.