Individual provider Active NPI

Roxanne Noelle Le Beau, MA, LPC, CADC

  • Addiction (Substance Use Disorder) Counselor
  • Racine, WI
National Provider Identifier
1689768012
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
21984 Issued in IL
Practice address
1220 Mound Ave
Suite 301
Racine, WI 53404-3350
Phone
(262) 633-3591
Fax
(262) 633-2619
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 21984 IL Primary
Professional Counselor 101YP2500X IL

Addresses

Primary practice location

1220 Mound Ave
Suite 301
Racine, WI 53404-3350

Mailing address

1220 Mound Ave
Suite 301
Racine, WI 53404-3350
Phone (262) 633-3591

Other identifiers 2

IdentifierTypeStateIssuer
21984OtherILCADC
40961600MedicaidWI

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 Arts

State licenses

LicenseStateTypeSpecialty
21984ILMDAddiction (Substance Use Disorder) Counselor
178-002818ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1689768012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 MOUND AVE",
            "address_2": "SUITE 301",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534043350",
            "telephone_number": "262-633-3591",
            "fax_number": "262-633-2619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 MOUND AVE",
            "address_2": "SUITE 301",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534043350",
            "telephone_number": "262-633-3591",
            "fax_number": "262-633-2619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE BEAU",
        "first_name": "ROXANNE",
        "middle_name": "NOELLE",
        "name_prefix": "Ms.",
        "credential": "MA, LPC, CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "21984",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CADC",
            "identifier": "21984",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40961600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.