NOELLE BENNETT (NPI# 1689189995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689189995 |
| Entity Type | Individual |
| Full Name | NOELLE BENNETT |
| Practice Address |
4615 E State St Ste 202 Rockford IL 61108-2158 |
| Mailing Address |
175 E Hawthorn Pkwy Ste 235 Vernon Hills IL 60061-1454 |
| Practice Telephone | 8478683435 |
| Practice Fax Number | 8478595885 |
| Mailing Telephone | 8477378768 |
| Mailing Fax Number | 8478595885 |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2018-10-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
178014161 | Behavioral Health & Social Service Providers | |
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699063446 | Noelle C Bennett | Physician Assistant | 3800 West Lincoln Way, Ames, IA 50010-3014 | 2011-07-14 |
| Street Address |
4615 E STATE ST STE 202 |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61108-2158 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073755526 | Andrea Reed | Counselor | 4615 E State St Ste 202, Rockford, IL 61108-2158 | 2009-03-30 |
| 1154944452 | Ashley Spickler | Counselor | 4615 E State St Ste 202, Rockford, IL 61108-2158 | 2020-05-20 |
| 1275162653 | Andrea Contreras | Dietitian, Registered | 4615 E State St Ste 202, Rockford, IL 61108-2158 | 2020-04-07 |
| 1104388420 | Kelsey Veilleux | Counselor | 4615 E State St Ste 202, Rockford, IL 61108-2158 | 2019-04-04 |
| 1730696113 | Alyssa Klehr | Dietitian, Registered | 4615 E State St Ste 202, Rockford, IL 61108-2158 | 2018-01-06 |
| 1700242666 | Sara Lynn Garl | Counselor | 4615 E State St Ste 202, Rockford, IL 61108-2158 | 2016-01-07 |
| 1134555881 | Alix Kavran | Counselor | 4615 E State St Ste 202, Rockford, IL 61108-2158 | 2013-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952862617 | Isr Enterprises, Inc. | Homemaker | 129 Phelps Ave, Bldg 10, Ste 1008, Rockford, IL 61108 | 2019-03-26 |
| 1003306465 | Adrienne Nicole Black | Behavior Technician | 519 Woodland Dr, Woodland Dr, Rockford, IL 61108 | 2018-05-11 |
| 1184085201 | Integrative Healing Center, LLC | Clinic/Center | 6019 Fincham Drive, Rockford, IL 61108 | 2016-03-17 |
| 1730547936 | Perryville Dentist PC | Dentist | 845 S Perryville Rd, Unit 119, Rockford, IL 61108 | 2016-02-02 |
| 1023489853 | Nicole Ping Ticknor | Counselor | 433 S. Phelps Ave., Suite 2, Rockford, IL 61108 | 2015-10-20 |
| 1275940348 | Northwest Home Care, Inc. | Home Health | 1437 S. Bell School Road, Suite 7, Rockford, IL 61108 | 2014-07-21 |
| 1487072922 | Alecia Greenlee | Psychiatry & Neurology | Rosecrance Community Mental Health, 3815 Harrison Avenue, Rockford, IL 61108 | 2014-04-02 |
| 1871925446 | Maria Laura Gustafson | Interpreter | 3208 Wesleyan Ave., Rockford, IL 61108 | 2013-08-06 |
| 1346582822 | Joseph Peevey | Pathology | 5666 E State Street, Department of Pathology, Rockford, IL 61108 | 2013-03-21 |
| 1134466923 | James Henry Peck | Hearing Instrument Specialist | 2424 Charles St, Rockford, IL 61108 | 2013-01-14 |
| Find all providers in zip 61108 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316571482 | Charles Theodore Strominger IIi | Counselor | 1003 N Prospect St, Rockford, IL 61107-3134 | 2020-02-27 |
| 1194366724 | Chelsie Ketton | Counselor | 2218 Custer Ave, Rockford, IL 61103-4374 | 2019-10-04 |
| 1467014282 | Ronald Charles Fleming Sr. | Counselor | 6408 Encantado Ct E, Rockford, MI 49341-9677 | 2019-07-01 |
| 1932685542 | Transformations Counseling Training and Consulting LLC | Counselor | 6066 Strathmoor Dr # C2, Rockford, IL 61107-6633 | 2018-07-17 |
| 1376045583 | Brittany Anne Bunton | Counselor | 5702 Elaine Dr. Suite 106, Rockford, IL 61108-2458 | 2018-03-03 |
| 1215435425 | Victor Hugo Mendoza | Counselor | 4623 Crescent Drive, Rockford, IL 61108-6110 | 2018-01-23 |
| 1639686538 | Lindsay M Lang Gluscic | Counselor | 915 Peter Ave, Rockford, IL 61108-3733 | 2018-01-02 |
| 1770975484 | Todd D Burd | Counselor | 6072 Brynwood Dr Ste 107a, Rockford, IL 61114-5829 | 2015-03-04 |
| 1083800601 | Lucille Anne Jenkins | Counselor | 2020 Glenview Rd, Rockford, IL 61107-1335 | 2007-09-18 |
| 1588790620 | Stephanie Anne Carey | Counselor | 5301 E State St Ste 302, Rockford, IL 61108-2399 | 2007-02-25 |
| Find all providers in ROCKFORD | ||||
Please comment or provide details below to improve the information on NOELLE BENNETT.
| 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.