Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1396221669 Individual Practitioner Female Practitioner

Emma Shackleton , LCPC

Counselor - Professional • Rockford, IL

Professional Overview & Biography Verified Profile Summary

Emma Shackleton, LCPC is a registered healthcare professional specializing in Counselor - Professional in Rockford, IL. Practice services are available at 695 N PERRYVILLE RD STE 4 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

695 N Perryville Rd Ste 4

Rockford, IL 611076225

Telephone 7793680060
Associated Practice Facility / Clinic
🏢 Kp Counseling Ltd Facility NPI 1770630766

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Rockford, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.6 Yrs
State Avg: 17.0 Yrs
Regional Practice Density
172 Specialists

Practicing in Rockford, IL (9683 Statewide)

Telehealth Adoption Rate
5.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-05-01
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License IL 180.014466

Definition to come...

Counselor

NUCC Taxonomy Code: 101Y00000X

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Secondary Practice Locations

8616 Northern Ave

Rockford, IL 611075309

Phone: 8153328003

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

27 Associated Practitioners
Gabrielle Lalor , LPC

Counselor - Professional

NPI 1043055601

Licensed Professional Counselor

James Johnson

Counselor - Professional

NPI 1083189120
Sonya Mcdevitt , LCPC

Counselor - Professional

NPI 1154803070

Licensed Clinical Professional Counselor

Gary Reeves , LCPC

Counselor - Professional

NPI 1154813327

Licensed Clinical Professional Counselor

Kimberly Henderson , LCSW

Social Worker - Clinical

NPI 1255956942

Licensed Clinical Social Worker

Amy Bruyn , LCPC

Counselor - Professional

NPI 1366930406

Licensed Clinical Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location May 01, 2023

Registered at 695 N PERRYVILLE RD STE 4, ROCKFORD, IL 611076225 (Tel: 7793680060)

📍
Updated Business Mailing Address May 01, 2023

Registered at 695 N PERRYVILLE RD STE 4, ROCKFORD, IL 611076225

👤
Provider Name / Credentials Updated May 01, 2023

Recorded as EMMA SHACKLETON, LCPC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 01, 2023

Counselor (License #180.014466 in IL)

NPI Profile Active July 19, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location July 19, 2018

Registered at 8616 NORTHERN AVE, ROCKFORD, IL 611075309 (Tel: 8153328003)

📍
Updated Business Mailing Address July 19, 2018

Registered at 1021 N MULFORD RD, ROCKFORD, IL 611073877

👤
Provider Name / Credentials Updated July 19, 2018

Recorded as EMMA SHACKLETON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 19, 2018

Counselor

🟢
Initial NPI Registration & Enumeration July 19, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1396221669
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 19, 2018
Last Update: May 01, 2023
Sole Proprietor: No

Mailing Address

695 N Perryville Rd Ste 4

Rockford, IL 611076225

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.