Active NPI
Renae Wood
- Marriage & Family Therapist
- Rockford, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 166001046
- Practice address
- 6392 Linden Rd
Rockford, IL 61109-2816 - Phone
- (779) 368-0060
- Fax
- (779) 368-0579
- NPI assigned
- Feb 19, 2016
- Last updated
- Feb 19, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 166001046 | IL | Primary |
Addresses
Primary practice location
6392 Linden Rd
Rockford, IL 61109-2816
Mailing address
6392 Linden Rd
Rockford, IL 61109-2816
Phone (779) 368-0060
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6392 Linden Rd
Rockford, IL 61109-2816
Phone (779) 368-0060
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 166001046 | IL | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optum Behavioral Care Therapy Services of Illinois PC | Current | Accepting new patients | |
| KP Counseling LTD | Current | Accepting new patients | |
| Optum Behavioral Care Therapy Services of Illinois PC | Current | Accepting new patients |
Locations
4753 N Broadway St
Ste 403
Chicago, IL 60640
Phone (773) 989-2780
12151 Regency Pkwy
Ste 12189
Huntley, IL 60142
Phone (779) 368-0660
1 Optum Cir
Eden Prairie, MN 55344
Phone (478) 234-8011
Organizations & group practices 3
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.
-
dba KP Counseling of Illinois
- Clinical Social Worker
- Rockford, IL
- NPI 1235949553
-
- Clinical Social Worker
- Rockford, IL
- NPI 1770630766
-
- Clinical Social Worker
- Rockford, IL
- NPI 1780579797
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739923200000",
"number": "1710346689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6392 LINDEN RD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611092816",
"telephone_number": "779-368-0060",
"fax_number": "779-368-0579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6392 LINDEN RD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611092816",
"telephone_number": "779-368-0060",
"fax_number": "779-368-0579"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "RENAE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-19",
"last_updated": "2025-02-19",
"certification_date": "2025-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IL",
"license": "166001046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.