Organization Active NPI

Amaryllis Mind, Body, & Soul Counseling

  • Mental Health Counselor
  • Swansea, IL
National Provider Identifier
1083496285
Registry record updated Oct 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
AMARYLLIS MIND, BODY, & SOUL COUNSELING
Practice address
209 W Pointe Dr Ste B
Swansea, IL 62226-8310
Phone
(314) 669-5060
NPI assigned
Oct 20, 2023
Last updated
Oct 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2026

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

Authorized official

Name
Yvonne Licavoli, LCPCNPI 1760113005
Title
Psychotherapist
Phone
(314) 397-1428

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

209 W Pointe Dr Ste B
Swansea, IL 62226-8310

Mailing address

209 W Pointe Dr Ste D
Swansea, IL 62226-8310
Phone (314) 669-5060

National Provider Directory

National Provider Directory

Locations

209 W Pointe Dr
Ste B
Swansea, IL 62226

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1697760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793059200000",
    "number": "1083496285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W POINTE DR STE D",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622268310",
            "telephone_number": "314-669-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W POINTE DR STE B",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622268310",
            "telephone_number": "314-669-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMARYLLIS MIND, BODY, & SOUL COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-20",
        "last_updated": "2026-10-27",
        "certification_date": "2026-10-27",
        "status": "A",
        "authorized_official_last_name": "LICAVOLI",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "314-397-1428",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Swansea, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2026; 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.