Individual provider Active NPI

Linda Thanh Nguyen, MS, LMFT

  • Marriage & Family Therapist
  • Rockford, IL
National Provider Identifier
1831307206
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
166000698 Issued in IL
Practice address
1330 E State St
Suite 4
Rockford, IL 61104-2251
Phone
(815) 608-3603
NPI assigned
May 18, 2007
Last updated
Feb 18, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 166000698 IL Primary

Addresses

Primary practice location

1330 E State St
Suite 4
Rockford, IL 61104-2251

Mailing address

1054 Vicar Close
Rockford, IL 61108-2586
Phone (815) 608-3603

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250606001000 IL Practitioner - Marriage and Family Therapist 1850801168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5844 Elaine Dr
Suite 101
Rockford, IL 61108-2494
Phone (815) 608-3603

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Linda Nguyen Marriage & Family Therapist CurrentSince Mar 6, 2025 Accepting new patients
Renita Shores-Gaston CurrentSince Mar 6, 2025 Accepting new patients

Locations

1330 E State St
Ste 4
Rockford, IL 61104
Phone (815) 608-3603

5844 Elaine Dr
Ste 101
Rockford, IL 61108
Phone (779) 970-8372

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455753600000",
    "number": "1831307206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1054 VICAR CLOSE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082586",
            "telephone_number": "815-608-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 E STATE ST",
            "address_2": "SUITE 4",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042251",
            "telephone_number": "815-608-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "LINDA",
        "middle_name": "THANH",
        "name_prefix": "Mrs.",
        "credential": "MS, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2016-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166000698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.