Aimee Rodolff, PSY.D., LCP, APIT

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071009403 Issued in IL

Practice address

1590 S Milwaukee Ave Ste 301
Libertyville, IL 60048-3786

Phone

(847) 220-8010

Fax

(847) 220-5918

NPI assigned

Mar 22, 2012

Sex

Female

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 15, 2023 through Feb 15, 2027

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Mental Health Revolution PLLC

  • Clinical Psychologist
  • Libertyville, IL
  • NPI 1679196588
  NPD Authorized official

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1942576004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1590 S MILWAUKEE AVE STE 301",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483786",
            "telephone_number": "847-220-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 S MILWAUKEE AVE STE 301",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483786",
            "telephone_number": "847-220-8010",
            "fax_number": "847-220-5918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODOLFF",
        "first_name": "AIMEE",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LCP, APIT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-22",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine M Robinson, CCC-SLP
• Mark Eric Robson, ATC
• Rockland Professional Group LLC
• Lynda Roden, DOSC
• Ellen Rodman-Stone, LCPC
• Isamar Rodriguez, DPT
• Lisa M Rodriguez, APRN
• Katherine Davy Roesler, PT
• Benjamin L Rojas Jr., D.O.
• Robert J Romanelli, M.D.

• Clinical Psychologist in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.