TAMMIE ROEDL


Address: 1802 S Mattis Ave, Champaign, IL 61821-5923
Phone: 2172559580

TAMMIE ROEDL (NPI# 1770034878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1770034878
Entity Type Individual
Full Name TAMMIE ROEDL
Credential LCSW
Practice Address 1802 S Mattis Ave
Champaign
IL 61821-5923
Mailing Address 611 W Park St.
Fapc
Urbana
IL 61801
Practice Telephone 2172559580
Enumeration Date 2016-10-24
Last Update Date 2020-01-29
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1041C0700X Social Worker
Specialization: Clinical
149014653 IL Behavioral Health & Social Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
309 W Clark St, Champaign, IL 618204637 2173989066 2173989077

Office Location

Street Address 1802 S MATTIS AVE
City CHAMPAIGN
State IL
Zip Code 61821-5923

Providers in the same location

NPI Name Taxonomy Address Enumeration
1568459030 Bart Wayne Gastwirth Podiatrist 1802 S Mattis Ave, Champaign, IL 61821-5923 2005-09-30
1982230124 Bradley Thompson Registered Nurse 1802 S Mattis Ave, Champaign, IL 61821-5923 2020-03-19
1710510136 Jeanie Mickelsen Social Worker 1802 S Mattis Ave, Champaign, IL 61821-5923 2020-02-13
1003456369 Rachael D Rubin Psychologist 1802 S Mattis Ave, Champaign, IL 61821-5923 2020-01-14
1114563640 Mary K Kiesewetter Nurse Practitioner 1802 S Mattis Ave, Champaign, IL 61821-5923 2019-11-19
1083255343 Lisa A. Ellingwood Registered Nurse 1802 S Mattis Ave, Champaign, IL 61821-5923 2019-10-07
1841843539 Rakisha Wilks Nurse Practitioner 1802 S Mattis Ave, Champaign, IL 61821-5923 2019-07-22
1558869081 Kristin E Thies Psychologist 1802 S Mattis Ave, Champaign, IL 61821-5923 2018-01-30
1215463971 Mercy E Eigbike Psychiatry & Neurology 1802 S Mattis Ave, Champaign, IL 61821-5923 2017-05-02
1881080372 Deanna Kane Nurse Practitioner 1802 S Mattis Ave, Champaign, IL 61821-5923 2015-04-10
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1326532888 Cunningham Children's Home of Urbana Il Residential Treatment Facility, Emotionally Disturbed Children 1303 N. Cunningham Avenue, Urbana, IL 61821 2018-06-19
1184008708 Seunghyun Jae Dentist 1905 W Springfield Ave, Champaign, IL 61821 2015-07-14
1457698169 Mohamad Ata Registered Nurse 1802 S. Mattis, Champaign, IL 61821 2013-01-15
1609124338 Lolitia Rosanna Newman Social Worker 1508 Powers Ln., Champaign, IL 61821 2012-08-28
1679850887 Kirk Donald Gohsman Counselor 106 S. Country Fair Drive, Suite C, Champaign, IL 61821 2011-11-16
1598054777 Delbert William Nelson Jr. Psychiatry & Neurology 2115 Galen Dr, Champaign, IL 61821 2011-03-28
1790946929 Rdi Vein LLC Clinic/Center 2502 Galen Drive, Suite 101, Champaign, IL 61821 2008-06-20
1366620064 Advanced Aesthetics Surgery & Laser Center, P.C. Clinic/Center 2111 West Park Ct., Champaign, IL 61821 2008-02-05
1033398482 Huey's Home Medical, Inc Durable Medical Equipment & Medical Supplies 1207 S Mattis Ave Ste 1, Champaign, IL 61821 2007-11-01
1265630537 Elizabeth Catherine Tingley Psychologist Department of Psychiatry and Psychology-carle Physician, 1802 S. Mattis, Champaign, IL 61821 2007-07-06
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Taxonomy Information

Taxonomy Code 1041C0700X
Grouping Behavioral Health & Social Service Providers
Classification Social Worker
Specialization Clinical

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1336759620 Telos Health and Wellness Services, LLC Social Worker 907 W Marketview Dr Ste 10, Champaign, IL 61822-1250 2020-08-03
1255963583 Jamey Richard Bailey Social Worker 701 Devonshire Drive, Bldg C, Suite 206, C-6, Champaign, IL 61820 2020-02-05
1932730835 Katina Wilcher Social Worker 609 Crestwood Dr, Champaign, IL 61822-7369 2020-01-29
1417596685 Heather Johnson Social Worker 1815 Crescent Dr, Champaign, IL 61821-5829 2020-01-05
1518425230 Kc Counseling, LLC Social Worker 206 N Randolph St Ste 508, Champaign, IL 61820-3949 2019-03-12
1134692536 Felicia Huiyan Li Social Worker 3115 Village Office Pl, Champaign, IL 61822-7673 2019-01-08
1528575958 David H. Crowley and Associates Ltd Social Worker 100 N Chestnut St Ste 231, Champaign, IL 61820-4856 2018-01-08
1356850457 Jessica L Wiley Social Worker 701 Devonshire Dr Ste B16-18, Champaign, IL 61820-7337 2017-09-21
1821518127 Molly Mclay Social Worker 309 W Clark St., Champaign, IL 61820 2017-06-27
1770938359 Champaign Counseling LLC Social Worker 313 N Mattis Ave Ste 209, C/o Erik Olson, Champaign, IL 61821-2461 2016-05-02
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Competitor

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City CHAMPAIGN
Zip Code 61821

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Dataset Information

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.

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