Individual provider Active NPI

Mary Ellen Rooney, LCPC

  • Professional Counselor
  • Shorewood, IL
National Provider Identifier
1780950774
Registry record updated Mar 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180-001293 Issued in IL
Practice address
620 Parkshore Dr
Shorewood, IL 60404-9752
Phone
(815) 744-5371
NPI assigned
Mar 24, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180-001293 IL Primary

Addresses

Primary practice location

620 Parkshore Dr
Shorewood, IL 60404-9752

Mailing address

620 Parkshore Dr
Shorewood, IL 60404-9752
Phone (815) 744-5371

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

State licenses

LicenseStateTypeSpecialty
180-001293ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1332547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332547200000",
    "number": "1780950774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 PARKSHORE DR",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604049752",
            "telephone_number": "815-744-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 PARKSHORE DR",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604049752",
            "telephone_number": "815-744-5371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROONEY",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-24",
        "last_updated": "2012-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-001293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shorewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2012; 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.