Kimberly M Rothwell

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

Organization subpart

No

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, LCPC

Title

Dance/Movement Therapist

Phone

(312) 968-3154

Specialties & licenses 2

Addresses

Locations

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": []
}

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• Professional Counselor in Glen Ellyn, IL
• Providers in Glen Ellyn, IL by specialty
• Professional Counselor in Illinois

• 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.