STATELINE COUNSELING SERVICES LLC (NPI# 1033551320) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033551320 |
| Entity Type | Organization |
| Organization Name | STATELINE COUNSELING SERVICES LLC |
| Practice Address |
1107 N Blackhawk Blvd Suite 8 Rockton IL 61072-1500 |
| Mailing Address |
2218 Crosby St Rockford IL 61107-4454 |
| Practice Telephone | 8154949115 |
| Practice Fax Number | 8159265301 |
| Mailing Telephone | 8154649115 |
| Mailing Fax Number | 8159265301 |
| Enumeration Date | 2013-07-26 |
| Last Update Date | 2013-07-26 |
| Authorized Official Name | MS. SHELLY LYNNE PATCHETT (OWNER) |
| Authorized Official Telephone | 8154949115 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149.009828 | IL | Behavioral Health & Social Service Providers |
| Street Address |
1107 N BLACKHAWK BLVD SUITE 8 |
| City | ROCKTON |
| State | IL |
| Zip Code | 61072-1500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215070487 | Shelly L Patchett | Social Worker | 1107 N Blackhawk Blvd, Suite 8, Rockton, IL 61072-1500 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750822649 | Brianna Helene Jensen | Specialist/Technologist | 11746 Deacon Dr, Rockton, IL 61072 | 2017-03-13 |
| 1891085767 | James Adrian Fogarty | Psychologist | 122 S. Prairie St. Suite A, Rockton, IL 61072 | 2011-04-13 |
| 1871623447 | Wal-mart Stores, Inc Dba Wal-mart | Technician/Technologist | 4781 E. Rockton Rd., Rockton, IL 61072 | 2007-03-06 |
| 1245301472 | Brandi M Lander | Counselor | 1107 N. Blackhawk Blvd, Suite 8, Rockton, IL 61072-1500 | 2006-11-10 |
| 1811987886 | Vasil Nika | Family Medicine | 1511 N Blackhawk Blvd, University Primary Care Clinic @ Rockton, Rockton, IL 61072-1513 | 2005-10-21 |
| 1245747971 | Nicole Atanasoff | Nurse Practitioner | 1511 N Blackhawk Blvd, Rockton, IL 61072-1513 | 2018-01-03 |
| 1588964712 | Carole J Eatock | Nurse Practitioner | 1511 N Blackhawk Blvd, Rockton, IL 61072-1513 | 2010-10-21 |
| 1952348831 | Board of Trustees of The University of Illinois | Family Medicine | 1511 N Blackhawk Blvd, Rockton, IL 61072-1513 | 2006-06-01 |
| 1316912462 | Leslie A Dean | Family Medicine | 1511 N Blackhawk Blvd, Univ Primary Care Clinic @ Rockton, Rockton, IL 61072-1513 | 2006-02-22 |
| 1215251061 | Kathleen Beth Mcguire | Counselor | 1116 Cannell Ct, Rockton, IL 61072-1551 | 2010-03-23 |
| Find all providers in zip 61072 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669962023 | Kathleen Reese | Social Worker | 158 Quantico Dr, Rockton, IL 61072-2820 | 2018-05-11 |
| 1215070487 | Shelly L Patchett | Social Worker | 1107 N Blackhawk Blvd, Suite 8, Rockton, IL 61072-1500 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447851241 | Courtney A Behrens | Social Worker | 150 Deerpath Rd, Algonquin, IL 60102-1861 | 2020-11-06 |
| 1801497623 | Sedulous Counseling & Consulting Services Pllc | Social Worker | 15255 S 94th Ave # 508, Orland Park, IL 60462-3800 | 2020-11-06 |
| 1295336022 | Web Healing Collective Pllc | Social Worker | 6207 N Springfield Ave, Chicago, IL 60659-1015 | 2020-11-06 |
| 1174124036 | Reginald Washington Edwards | Social Worker | 18660 Walnut Ave, Country Club Hills, IL 60478-5549 | 2020-11-05 |
| 1881295186 | Belva Marie Dibert | Social Worker | 6330 S Ingleside Ave Apt 3, Chicago, IL 60637-5784 | 2020-11-03 |
| 1801496468 | Monica Dushane | Social Worker | 125 N Buffalo Grove Rd Apt 110, Buffalo Grove, IL 60089-1722 | 2020-10-31 |
| 1528668373 | Stephanie Caballero Novak | Social Worker | Life Care Wellness, Inc., 800 Roosevelt Rd Building C Suite 206, Glen Ellyn, IL 60137 | 2020-10-30 |
| 1598365488 | Karyssa Lee Haase | Social Worker | 745 E Court St, Paris, IL 61944-2460 | 2020-10-29 |
| 1699375592 | Andrea Doherty | Social Worker | 526 Keystone Ave, River Forest, IL 60305-1612 | 2020-10-29 |
| 1861092835 | Lauren Less | Social Worker | 111 East Pearson St, Chicago, IL 60611 | 2020-10-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.