Individual provider Active NPI

Rosa Vera King, LCPC

  • Mental Health Counselor
  • Homewood, IL
National Provider Identifier
1710368352
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
935 175TH St Ste 100
Homewood, IL 60430-2073
Phone
(733) 888-9830
Fax
(309) 240-9591
NPI assigned
Jun 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

935 175TH St Ste 100
Homewood, IL 60430-2073

Mailing address

935 175TH St Ste 100
Homewood, IL 60430-2073
Phone (773) 888-9830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240813002823 IL Practitioner - Mental Health Counselor 3779021407 Reassigns benefits to 3 organizations
I20260521002244 IN Practitioner - Mental Health Counselor 3779021407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7951 Calumet Ave
Suite 1238
Munster, IN 46321-1215
Phone (773) 888-9830

935 175TH St
Suite 100
Homewood, IL 60430-2073
Phone (773) 888-9830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Nature Therapy and Wellness PLLC CurrentSince Apr 1, 2023 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Aug 27, 2024 Accepting new patients
MHN Infusions Group LLC CurrentSince May 31, 2024 Accepting new patients

Locations

605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338

935 175th St
Ste 307
Homewood, IL 60430
Phone (708) 726-8126

935 175th St
Ste 100
Homewood, IL 60430
Phone (773) 888-9830

7951 Calumet Ave
#1238
Munster, IN 46321

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1710368352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 175TH ST STE 100",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302073",
            "telephone_number": "773-888-9830",
            "fax_number": "309-240-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 175TH ST STE 100",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302073",
            "telephone_number": "733-888-9830",
            "fax_number": "309-240-9591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "ROSA",
        "middle_name": "VERA",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-09",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

Verify at the official NPI Registry.