ANN MARIE PETTY


Address: 1200 W State St, Rockford, IL 61102-2112
Phone: 8154901600

ANN MARIE PETTY (NPI# 1770991820) 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) 1770991820
Entity Type Individual
Full Name ANN MARIE PETTY
Credential LCSW,CADC
Practice Address 1200 W State St
Rockford
IL 61102-2112
Practice Telephone 8154901600
Practice Fax Number 8154901881
Mailing Telephone 8154901600
Mailing Fax Number 8154901881
Enumeration Date 2014-07-31
Last Update Date 2020-03-10
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
18135 IL Behavioral Health & Social Service Providers
Y 1041C0700X Social Worker
Specialization: Clinical
149009048 IL Behavioral Health & Social Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
8616 Northern Ave, Rockford, IL 611075309 8153326024
8616 Northern Ave, Rockford, IL 611075309 8153999700

Other Providers ANN PETTY

NPI Name Taxonomy Address Enumeration
1700011855 Ann K. Petty Specialist 5914 Valley Forge Dr, Houston, TX 77057-1932 2009-05-19

Office Location

Street Address 1200 W STATE ST
City ROCKFORD
State IL
Zip Code 61102-2112

Providers in the same location

NPI Name Taxonomy Address Enumeration
1780680827 Barbara B Morgan Nurse Practitioner 1200 W State St, Rockford, IL 61102-2112 2005-06-23
1588271894 Angela Siebold Nurse Practitioner 1200 W State St, Rockford, IL 61102-2112 2020-09-30
1942814322 Jacqueline Paige Cabrera Nurse Practitioner 1200 W State St, Rockford, IL 61102-2112 2020-09-03
1285250951 Aaleeyah Pringle Alim Dentist 1200 W State St, Rockford, IL 61102-2112 2020-06-18
1639792419 Jessica Lauren Cole Physician Assistant 1200 W State St, Rockford, IL 61102-2112 2020-05-27
1437779071 Christian Murillo Physician Assistant 1200 W State St, Rockford, IL 61102-2112 2020-04-23
1033746573 Erin Ashleigh Donahue Physician Assistant 1200 W State St, Rockford, IL 61102-2112 2020-03-25
1609406008 Marissa Dreger Family Medicine 1200 W State St, Rockford, IL 61102-2112 2020-01-24
1962041657 Sabrina Lee Puvalowski Physician Assistant 1200 W State St, Rockford, IL 61102-2112 2019-12-30
1932741717 Jacob Dalton Boehm Physician Assistant 1200 W State St, Rockford, IL 61102-2112 2019-10-12
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1205115383 Renee Lynn Keeney Advanced Practice Midwife 1200 W. State Street, Crusader Community Health, Rockford, IL 61102 2011-08-08
1689895906 Linda Lou O'reilly Local Education Agency (LEA) 1515 S. Meridian Road, Rockford, IL 61102 2007-05-02
1801012992 Jennifer Anne Boyd Developmental Therapist Nia 1515 S. Meridian Rd., Rockford, IL 61102 2007-04-17
1609173434 Kellie J Gibbons Registered Nurse 650 W State Street, Winnebago County Jail Medical Unit, Rockford, IL 61102-0000 2011-02-14
1275708752 Mercy Ambulance Service LLC Ambulance 1025 Campton Dr, Rockford, IL 61102-1066 2008-04-25
1417448424 Brittany Nicole Lambert Student in an Organized Health Care Education/Training Program 8040 Towermont Dr, Rockford, IL 61102-1080 2018-05-24
1164490132 Harlan Johnson Counselor 852 Lakewood Dr, Rockford, IL 61102-1228 2006-03-08
1184137283 Gail Mary Swenson Speech-Language Pathologist 730 Lincoln Park Blvd, Rockford, IL 61102-1429 2017-11-10
1659316339 Institute of Family Care Home Health 417 S Pierpont Ave, Rockford, IL 61102-1656 2006-06-18
1861851438 Walgreen Co Durable Medical Equipment & Medical Supplies 1200 W State St Ste 102, Rockford, IL 61102-2112 2016-02-11
Find all providers in zip 61102

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
1306444070 Susan Glover Social Worker 65 S Main St Lowr Level, Rockford, MI 49341-1286 2020-10-14
1669085445 Lorri Ann Romesberg Social Worker 5738 Dorado Ct Ne, Rockford, MI 49341-8335 2020-08-31
1063020246 Samantha Lane Social Worker 5402 Applewood Close, Rockford, IL 61114-5490 2020-07-14
1518587872 Laura Kathleen Lindell Social Worker 4003 Mila Ave, Rockford, IL 61101-5069 2020-04-16
1548895527 Stephanie Syverson Social Worker 695 N Perryville Rd Ste 4, Rockford, IL 61107-6225 2020-03-10
1508497975 Laurie Hadler Social Worker 740 Tulip Ln, Rockford, IL 61107-5828 2020-02-03
1538708243 Nicole Elizabeth Rundall-royal Social Worker 1302 Thoren Ln, Rockford, IL 61107-2662 2019-12-27
1568006096 Bridget Denise Mcknight Social Worker 5959 Forest Trail Dr, Rockford, IL 61109-6535 2019-10-28
1538716105 Geiselhart Solution Focused Therapy, LLC Social Worker 4102 Will Ann Dr, Rockford, IL 61101-6047 2019-08-20
1548816184 Amy Hultman Social Worker 4320 Spring Creek Rd Ste 9, Rockford, IL 61107-1157 2019-08-09
Find all providers in ROCKFORD

Competitor

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City ROCKFORD
Zip Code 61102

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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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