Susan L Rick, LCPC
Individual provider Active NPI Mental Health Counselor · Oglesby, IL
NPI 1992567713 · NPPES record last updated Jan 26, 2024
Key facts
- NPI
- 1992567713
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 180.013829 (IL)
- Practice address
- 473 N 2259TH Rd
Oglesby, IL 61348-9522 - Phone
- (815) 814-7961
- NPI assigned
- Jan 26, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250618002733 | IL | Practitioner - Mental Health Counselor | 1456862192 | Practice locations: Oglesby, IL |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180.013829 | IL | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 180.013829 | IL | Yes |
Addresses
Primary practice location
473 N 2259TH Rd
Oglesby, IL 61348-9522
Mailing address
473 N 2259TH Rd
Oglesby, IL 61348-9522
Phone (815) 814-7961
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All providers in Oglesby, IL · Mental Health Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.