LAURA PENNA (NPI# 1700920220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700920220 |
| Entity Type | Individual |
| Full Name | LAURA PENNA |
| Credential | L.C.P.C. |
| Practice Address |
8616 Northern Ave Rockford IL 61107-5309 |
| Practice Telephone | 8153911000 |
| Practice Fax Number | 8153326090 |
| Mailing Telephone | 8153911000 |
| Mailing Fax Number | 8153326090 |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2015-03-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
180004909 | IL | Behavioral Health & Social Service Providers |
| Street Address |
8616 NORTHERN AVE |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61107-5309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245217959 | Raymond Christopher Garcia | Psychiatry & Neurology | 8616 Northern Ave, Rockford, IL 61107-5309 | 2005-12-23 |
| 1659930956 | Margaret L Loy | Psychologist | 8616 Northern Ave, Rockford, IL 61107-5309 | 2019-06-10 |
| 1366005779 | Jacob Urbelis | Counselor | 8616 Northern Ave, Rockford, IL 61107-5309 | 2019-04-22 |
| 1679032692 | Asia E Mueller | Registered Nurse | 8616 Northern Ave, Rockford, IL 61107-5309 | 2019-03-19 |
| 1134688179 | Lori Martineau | Social Worker | 8616 Northern Ave, Rockford, IL 61107-5309 | 2019-03-19 |
| 1669931689 | Christina Renee Kelley | Registered Nurse | 8616 Northern Ave, Rockford, IL 61107-5309 | 2019-03-19 |
| 1497220388 | Jermaine E Tolefree | Counselor | 8616 Northern Ave, Rockford, IL 61107-5309 | 2018-10-08 |
| 1699253617 | Lakeysha Watkins | Counselor | 8616 Northern Ave, Rockford, IL 61107-5309 | 2018-08-01 |
| 1528546587 | Kelsey E Hayes | Counselor | 8616 Northern Ave, Rockford, IL 61107-5309 | 2018-08-01 |
| 1417435652 | Shannon Marie Ferriter | Counselor | 8616 Northern Ave, Rockford, IL 61107-5309 | 2018-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
| 1467092379 | Unknown Safa Fatima | Student in an Organized Health Care Education/Training Program | Mercyhealth Mulford Clinic, 5970 Churchview Drive, Rockford, IL 61107 | 2020-01-08 |
| 1194367912 | Matt J Kriebs | Nurse Practitioner | 1235 N Mulford Rd Suite 103, Rockford, IL 61107 | 2019-10-14 |
| 1265962336 | Mary Golembeck | Nurse Practitioner | 7290 Argus Dr, Rockford, IL 61107 | 2017-06-12 |
| 1831644749 | Tessa Lee | Occupational Therapist | 3422 Lauderdale Ln, Rockford, IL 61107 | 2016-08-20 |
| 1942626965 | Elevated Health Essentials, LLC | Chiropractor | 124 N Water St Ste 204e, Rockford, IL 61107 | 2014-03-14 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
| 1023358272 | Lavanya Durairajan | Physical Therapist | 7358 Shiligton Dr, Rockford, IL 61107 | 2013-02-26 |
| 1851523146 | Great Smiles of Rockford | Durable Medical Equipment & Medical Supplies | 780 N. Mulfrord Road, Rockford, IL 61107 | 2009-08-20 |
| Find all providers in zip 61107 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114536406 | Jennifer Amy Stone | Counselor | 4433 Hillrise Ct Ne, Rockford, MI 49341-9651 | 2020-07-23 |
| 1992346605 | Cara Kimble | Counselor | 308 W State St Ste 250, Rockford, IL 61101-1140 | 2019-10-03 |
| 1932753258 | Dimensions of Wellness and Transformation, Inc | Counselor | 3701 E State St Ste H, Rockford, IL 61108-1975 | 2019-07-25 |
| 1871094870 | Rachel Schultz | Counselor | 1639 N Alpine Rd Ste 403, Rockford, IL 61107-1440 | 2018-02-24 |
| 1669987806 | Jilian Santander Rakow | Counselor | 10525 Edgerton Ave Ne, Rockford, MI 49341-9120 | 2017-12-11 |
| 1184072126 | Carlton Martin | Counselor | 5896 Creekside Ln, Rockford, IL 61114-6466 | 2016-06-01 |
| 1003273830 | Darcy Krause | Counselor | 6556 Bella Vista Dr Ne, 26 N Main St, Rockford, MI 49341-7861 | 2016-01-25 |
| 1023489853 | Nicole Ping Ticknor | Counselor | 433 S. Phelps Ave., Suite 2, Rockford, IL 61108 | 2015-10-20 |
| 1003283169 | Bren Shantz | Counselor | 4890 11 Mile Rd Ne, Rockford, MI 49341-8477 | 2015-08-25 |
| 1710371406 | Rebecca Gielow | Counselor | 2518 Whitmire Dr, Rockford, IL 61109-6732 | 2015-03-20 |
| Find all providers in ROCKFORD | ||||
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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.