Ant Walach

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

6072 Brynwood Dr Ste 205
Rockford, IL 61114-5829

Phone

(815) 846-0684

NPI assigned

Aug 15, 2025

Last updated

Aug 15, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Mosaic Counseling Services, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rockford, IL
  • NPI 1205570843
  NPD (past)

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

{
    "created_epoch": "1755216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1962388629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11128 HAMBORG RD",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "610739111",
            "telephone_number": "510-590-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6072 BRYNWOOD DR STE 205",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611145829",
            "telephone_number": "815-846-0684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALACH",
        "first_name": "ANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Elizabeth Wagner, APRN
• Patti J Wakefield, PT
• Wal-Mart Stores, Inc (Vision Center 30-1490)
• Wal-Mart Stores, Inc (Vision Center 30-5398)
• Wal-Mart Stores, Inc (Vision Center 30-1955)
• Jessica Patricia Walberg, PA-C
• Walgreen Co (Walgreens #07069)
• Walgreen Co (Walgreens #02828)
• Walgreen Co (Walgreens #04777)
• Walgreen Co (Walgreens #09127)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.