Aimee Anderson, QMHP
Individual provider Active NPI Counselor · Macomb, IL
NPI 1104394295 · NPPES record last updated Nov 6, 2018
Key facts
- NPI
- 1104394295
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 900 S Deer Rd
Macomb, IL 61455-2639 - Phone
- (309) 837-4876
- Fax
- (309) 833-1531
- NPI assigned
- Nov 6, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240830003023 | IL | Practitioner - Mental Health Counselor | 0244779478 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McDonough County Hospital District | Current | Accepting new patients | |
| McDonough County Hospital District | Current |
Accepting new patients | |
| McDonough County Hospital District | Current | Accepting new patients | |
| McDonough County Hospital District | Current | Accepting new patients | |
| McDonough County Hospital District | Current | Accepting new patients | |
| McDonough County Hospital District | Current | Accepting new patients | |
| McDonough County Hospital District | Current |
Accepting new patients |
Locations
505 E Grant St
Ste 310
Macomb, IL 61455
Phone (309) 836-1582
525 E Grant St
Macomb, IL 61455
Phone (309) 836-1611
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/9c9d3cdf-0f7f-4b63-979a-f711747b3e95/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
900 S Deer Rd
Macomb, IL 61455-2639
Mailing address
900 S Deer Rd
Macomb, IL 61455-2639
Phone (309) 837-4876
Other providers in Macomb, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.