Michael John Oldenburg, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

178.017532 Issued in IL

Practice address

3815 Harrison Ave
Rockford, IL 61108-7631

Phone

(815) 540-6151

NPI assigned

Nov 9, 2021

Last updated

Nov 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Rosecrance Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rockford, IL
  • NPI 1013289446
  Medicare reassignment
• Rosecrance Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Kankakee, IL
  • NPI 1609576214
  NPD
• Rosecrance Inc

  dba Rosecrance

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Moline, IL
  • NPI 1639892698
  NPD

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1851057475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 N MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 HARRISON AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611087631",
            "telephone_number": "815-540-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDENBURG",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-09",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178.017532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine K Ojeda, LCPC
• Edwin Okeson, MD
• Fiona Uzoamaka Okoroti, APRN-FPA, AGPCNP-BC
• Ayobami David Olaleye, MD
• Omobolaji Olanrewaju, PHARMD
• Megan Olejnik, LCSW
• Stephanie Oleston, LATC
• Phil Oliveri, PT
• Thomas Stephen Olsen, DPT
• Jennifer Shanti Olson, LMFT

• Counselor in Rockford, IL
• Providers in Rockford, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.