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 IDStateProvider typePAC IDDetails
I20250618002733 IL Practitioner - Mental Health Counselor 1456862192 Practice locations: Oglesby, IL

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
180.013829ILMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Oglesby, IL

All providers in Oglesby, IL · Mental Health Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.