NPIMap

Organization Active NPI

Rock River Valley Mental Health, LLC

  • Adult Mental Health Clinic/Center
  • Dixon, IL
National Provider Identifier
1922326875
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
071.007278 Issued in IL
Legal business name
ROCK RIVER VALLEY MENTAL HEALTH, LLC
Practice address
631 Willett Ave
Dixon, IL 61021-2348
Phone
(815) 284-6111
NPI assigned
May 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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

Authorized official

Name
Dr. Carolyn Sue Van Doren, PSY. D.
Title
Director
Phone
(815) 284-6111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 071.007278 IL Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 071.007278 IL

Addresses

Primary practice location

631 Willett Ave
Dixon, IL 61021-2348

Mailing address

PO Box 564
Dixon, IL 61021-0564
Phone (815) 284-6111

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1273968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330560000000",
    "number": "1922326875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 564",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610210564",
            "telephone_number": "815-284-6111",
            "fax_number": "815-284-6114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 WILLETT AVE",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610212348",
            "telephone_number": "815-284-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK RIVER VALLEY MENTAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-16",
        "last_updated": "2012-03-01",
        "status": "A",
        "authorized_official_last_name": "VAN DOREN",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "815-284-6111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY. D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "IL",
            "license": "071.007278",
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "IL",
            "license": "071.007278",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; 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.