Ann Marie Petty, LCSW,CADC is a medicare enrolled "Social Worker - Clinical" provider in Rockford, Illinois. She went to University Of Illinois College Of Med (chi/peor/rock/chm-urb) and graduated in 1998 and has 26 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Crusaders Central Clinic Association and her current practice location is
1200 W State St, Rockford, Illinois. You can reach out to her office (for appointments etc.) via phone at
(815) 490-1600.
Ann Marie Petty is licensed to practice in Illinois (license number 149009048) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1770991820.
Healthcare Provider's Profile
| Full Name | Ann Marie Petty |
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| Gender | Female |
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| Speciality | Clinical Social Worker |
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| Experience | 26 Years |
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| Location | 1200 W State St, Rockford, Illinois |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Ann Marie Petty attended and graduated from University Of Illinois College Of Med (chi/peor/rock/chm-urb) in 1998
NPI Data:
- NPI Number: 1770991820
- Provider Enumeration Date: 07/31/2014
- Last Update Date: 03/10/2020
Medicare PECOS Information:
- PECOS PAC ID: 5294708301
- Enrollment ID: I20040817000786
Medical Identifiers
Medical identifiers for Ann Marie Petty such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1770991820 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 18135 (Illinois) | Secondary |
| 1041C0700X | Social Worker - Clinical | 149009048 (Illinois) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Crusaders Central Clinic Association | 5799682993 | 15 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ann Marie Petty allows following entities to bill medicare on her behalf.
| Entity Name | Aspen Counseling & Consulting Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1326288994
PECOS PAC ID: 9335376805
Enrollment ID: O20131209001589 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ann Marie Petty is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ann Marie Petty, LCSW,CADC
1200 W State St,
Rockford, IL 61102-2112
Ph: (815) 490-1600 | Ann Marie Petty, LCSW,CADC
1200 W State St,
Rockford, IL 61102-2112
Ph: (815) 490-1600 |
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