Individual provider Active NPI

Danielle G Stoddard, LCPC

  • Mental Health Counselor
  • La Salle, IL
National Provider Identifier
1902956220
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180-006374 Issued in IL
Practice address
2428 Chartres St
La Salle, IL 61301-1107
Phone
(815) 780-8765
NPI assigned
Jan 11, 2007
Last updated
Jun 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180-006374 IL Primary

Addresses

Primary practice location

2428 Chartres St
La Salle, IL 61301-1107

Mailing address

PO Box 185
304 N Milwaukee St
Mark, IL 61340-0185
Phone (309) 830-1096

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
I20240403000141 IL Practitioner - Mental Health Counselor 6507115185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life Balance Counseling and Wellness IncGroup PAC ID 8325397904, 9 clinicians

Practice addresses (Care Compare)

2218 Marquette Rd
Peru, IL 61354-1538
Phone (815) 780-8765

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180-006374ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Life Balance Counseling and Wellness Inc Mental Health CurrentSince Jun 1, 2018 Accepting new patients
Illinois Valley Counseling Services Past Accepting new patients

Locations

2428 Chartres St
La Salle, IL 61301
Phone (309) 830-1096

2218 Marquette Rd
Peru, IL 61354
Phone (815) 223-7970

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1902956220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 185",
            "address_2": "304 N MILWAUKEE ST",
            "city": "MARK",
            "state": "IL",
            "postal_code": "613400185",
            "telephone_number": "309-830-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 CHARTRES ST",
            "city": "LA SALLE",
            "state": "IL",
            "postal_code": "613011107",
            "telephone_number": "815-780-8765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STODDARD",
        "first_name": "DANIELLE",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180-006374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Salle, IL

Sources for this page

Verify at the official NPI Registry.