Ashley Dawn Amburn, LCPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

180.010153 Issued in IL

Practice address

938 Evan Dr
O Fallon, IL 62269-3471

Phone

(618) 531-9637

NPI assigned

Mar 24, 2016

Last updated

Nov 14, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hoyleton Youth and Family Services

  • Foster Care Agency
  • Fairview Heights, IL
  • NPI 1083073977
  Medicare reassignment NPD

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

{
    "created_epoch": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1043672512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "938 EVAN DR",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693471",
            "telephone_number": "618-531-9637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "938 EVAN DR",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693471",
            "telephone_number": "618-531-9637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBURN",
        "first_name": "ASHLEY",
        "middle_name": "DAWN",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-24",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180.010153",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.010153",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amanda's SLP Care LLC
• Amedisys Illinois LLC (Amedisys Home Health)
• Akossiwa Amenyo, HAIR LOSS SPECIALIST
• Ronald P Ames, DMD
• Candace Mary Amesquita
• Nicole A Amos, PT

• Counselor in O'Fallon, IL
• Providers in O'Fallon, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.