Active NPI
Amanda Brandimore
- Mental Health Counselor
- Chicago, IL
National Provider Identifier
1053050302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1147 W Ohio St
Chicago, IL 60642-6472 - Phone
- (312) 772-9796
- NPI assigned
- Jun 2, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1147 W Ohio St
Chicago, IL 60642-6472
Mailing address
616 E Liberty Dr
Wheaton, IL 60187-5515
Phone (586) 243-9461
Other practice location 1
7366 N Lincoln Ave
Lincolnwood, IL 60712-1708
Phone (847) 485-9060
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654128000000",
"number": "1053050302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "616 E LIBERTY DR",
"city": "WHEATON",
"state": "IL",
"postal_code": "601875515",
"telephone_number": "586-243-9461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1147 W OHIO ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606426472",
"telephone_number": "312-772-9796"
}
],
"practiceLocations": [
{
"address_1": "7366 N Lincoln Ave",
"address_purpose": "LOCATION",
"city": "Lincolnwood",
"state": "IL",
"postal_code": "607121708",
"country_code": "US",
"telephone_number": "847-485-9060",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRANDIMORE",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-02",
"last_updated": "2022-06-02",
"certification_date": "2022-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.