Individual provider Active NPI

Martha L Dennen, LCPC

  • Professional Counselor
  • Wheaton, IL
National Provider Identifier
1841438595
Registry record updated May 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180007697 Issued in IL
Practice address
1616 E Roosevelt Rd
Wheaton, IL 60187-6850
Phone
(630) 588-1201
Fax
(630) 588-1209
NPI assigned
Feb 2, 2009
Last updated
May 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 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 180007697 IL Primary

Addresses

Primary practice location

1616 E Roosevelt Rd
Wheaton, IL 60187-6850

Mailing address

1616 E Roosevelt Rd
Suite 8
Wheaton, IL 60187-6850
Phone (630) 588-1201

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
I20240223001227 IL Practitioner - Mental Health Counselor 8224403118 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life Care Wellness, Inc.Group PAC ID 2860791449, 14 clinicians

Practice addresses (Care Compare)

800 Roosevelt Rd
Suite C206
Glen Ellyn, IL 60137-5851
Phone (630) 423-5935

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Life Care Wellness, Inc. Professional CurrentSince Jan 2, 2024 Accepting new patients

Locations

800 Roosevelt Rd
Ste C206
Glen Ellyn, IL 60137
Phone (630) 423-5935

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": "1233532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336608000000",
    "number": "1841438595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 E ROOSEVELT RD",
            "address_2": "SUITE 8",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601876850",
            "telephone_number": "630-588-1201",
            "fax_number": "630-588-1209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 E ROOSEVELT RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601876850",
            "telephone_number": "630-588-1201",
            "fax_number": "630-588-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNEN",
        "first_name": "MARTHA",
        "middle_name": "L",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-02",
        "last_updated": "2012-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180007697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.