Individual provider Active NPI

Ashley Beth Sturdivant, LCPC

  • Professional Counselor
  • Rockford, IL
National Provider Identifier
1801079363
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.014074 Issued in IL
Practice address
6787 Flower Hill Rd
Rockford, IL 61114-6636
Phone
(816) 674-2648
NPI assigned
Dec 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1869 KS
Professional Counselor 101YP2500X 180.014074 IL Primary

Addresses

Primary practice location

6787 Flower Hill Rd
Rockford, IL 61114-6636

Mailing address

6787 Flower Hill Rd
Rockford, IL 61114-6636
Phone (816) 674-2648

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
180.014074ILMDProfessional Counselor
1869KSMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1801079363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6787 FLOWER HILL RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611146636",
            "telephone_number": "816-674-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6787 FLOWER HILL RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611146636",
            "telephone_number": "816-674-2648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURDIVANT",
        "first_name": "ASHLEY",
        "middle_name": "BETH",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-07",
        "last_updated": "2025-01-03",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "1869",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.014074",
            "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 Jan 3, 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.