NPIMap

Organization Active NPI

Kimberly M Rothwell

  • Professional Counselor
  • Glen Ellyn, IL
National Provider Identifier
1962830786
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.007496 Issued in IL
Legal business name
KIMBERLY M ROTHWELL
Practice address
460 N Main St
Suite 302
Glen Ellyn, IL 60137-5176
Phone
(312) 968-3154
NPI assigned
Oct 15, 2013
Last updated
Feb 7, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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

Authorized official

Name
Kimberly Rothwell, M.A. BC-DMT, LCPCNPI 1275071532
Title
Dance/Movement Therapist
Phone
(312) 968-3154

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 28374
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 180.007496 IL Primary

Addresses

Primary practice location

460 N Main St
Suite 302
Glen Ellyn, IL 60137-5176

Mailing address

838 Hill Ave
Glen Ellyn, IL 60137-5207

National Provider Directory

National Provider Directory

Locations

460 N Main St
Ste 302
Glen Ellyn, IL 60137
Phone (312) 968-3154

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1381795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486425600000",
    "number": "1962830786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 HILL AVE",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601375207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 N MAIN ST",
            "address_2": "SUITE 302",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601375176",
            "telephone_number": "312-968-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY M ROTHWELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-15",
        "last_updated": "2017-02-07",
        "status": "A",
        "authorized_official_last_name": "ROTHWELL",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "DANCE/MOVEMENT THERAPIST",
        "authorized_official_telephone_number": "312-968-3154",
        "authorized_official_credential": "M.A. BC-DMT, LCPC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": "28374",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.007496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ellyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; 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.