Individual provider Active NPI

Richard Allen Risberg, MA LCPC CRADC

  • Mental Health Counselor
  • Bloomington, IL
National Provider Identifier
1902909484
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
101 W Monroe
Suite 205
Bloomington, IL 61701
Phone
(309) 242-4414
Fax
(309) 828-4525
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X IL
Mental Health Counselor 101YM0800X IL Primary

Addresses

Primary practice location

101 W Monroe
Suite 205
Bloomington, IL 61701

Mailing address

101 W Monroe
Suite 205
Bloomington, IL 61701
Phone (309) 242-4414

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
180-001464ILMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1902909484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W MONROE",
            "address_2": "SUITE 205",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61701",
            "telephone_number": "309-242-4414",
            "fax_number": "309-828-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W MONROE",
            "address_2": "SUITE 205",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61701",
            "telephone_number": "309-242-4414",
            "fax_number": "309-828-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISBERG",
        "first_name": "RICHARD",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "MA LCPC CRADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.