Amanda Bevacqua, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

166000656 Issued in IL

Practice address

2334 W Lawrence Ave
Suite 212
Chicago, IL 60625-1948

Phone

(773) 988-5147

NPI assigned

May 13, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281052800000",
    "number": "1023336088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4845 N SPRINGFIELD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606256213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2334 W LAWRENCE AVE",
            "address_2": "SUITE 212",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606251948",
            "telephone_number": "773-988-5147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVACQUA",
        "first_name": "AMANDA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-13",
        "last_updated": "2010-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166000656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tessa R Beukema, LCPC
• Kyle J Beuoy, MD
• Shannon Beussink, DPT
• Lisa Rachel Beutler
• Gabriela Bevacqua-Collins, LPC
• Carolyn Jean Bevan, MD
• Jillian Bevan
• Bevel Up Medical Services
• Grace A Beveridge, PA-C
• Jennifer Lynn Beverlin, D.C.

• Marriage & Family Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Marriage & Family Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.