Active NPI
Jessica Marie Norman, MS, LMFT, CADC
- Marriage & Family Therapist
- Rockford, IL
National Provider Identifier
1669715173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 166001087
- Practice address
- 3815 Harrison Ave
Rockford, IL 61108-7631 - Phone
- (815) 387-2453
- Fax
- (815) 387-7997
- NPI assigned
- Apr 3, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 321-228 | WI | |
| Mental Health Counselor | 101YM0800X | 16793-130 | WI | |
| Marriage & Family Therapist | 106H00000X | 166001087 | IL | Primary |
Addresses
Primary practice location
3815 Harrison Ave
Rockford, IL 61108-7631
Mailing address
3815 Harrison Ave
Rockford, IL 61108-7631
Phone (815) 387-2453
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16793-130 | WI | MD | Mental Health Counselor |
| 321-228 | WI | MD | Mental Health Counselor |
| 166001087 | IL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477612800000",
"number": "1669715173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3815 HARRISON AVE",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611087631",
"telephone_number": "815-387-2453",
"fax_number": "815-387-7997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3815 HARRISON AVE",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611087631",
"telephone_number": "815-387-2453",
"fax_number": "815-387-7997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORMAN",
"first_name": "JESSICA",
"middle_name": "MARIE",
"credential": "MS, LMFT, CADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-03",
"last_updated": "2016-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WI",
"license": "321-228",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WI",
"license": "16793-130",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IL",
"license": "166001087",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
- Erika Kristin Nordlof, RTR
- Patricia J Nordman, N.P.
- Nathan Norem, D.P.M.
- Brooke Marie Norman, PHARMD
- Emily Michaela Norman, DPT
- Jerald Ray Norquist, P.C.
- Taylor Ann Norris, APRN, FNP-BC
- North Main Nursing and Rehab Center
- Northern Illinois Behavioral Health Group
- Northern Illinois Hospice Association
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.