Active NPI
Amanda Brewer
- Professional Counselor
- Tolono, IL
National Provider Identifier
1124854807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 178.020550
- Practice address
- PO Box 752
Tolono, IL 61880-0752 - Phone
- (765) 390-1186
- NPI assigned
- Sep 10, 2024
- Last updated
- Sep 10, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178.020550 | IL | Primary |
Addresses
Primary practice location
PO Box 752
Tolono, IL 61880-0752
Mailing address
PO Box 752
Tolono, IL 61880-0752
Phone (765) 390-1186
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.020550 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725926400000",
"number": "1124854807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 752",
"city": "TOLONO",
"state": "IL",
"postal_code": "618800752",
"telephone_number": "765-390-1186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 752",
"city": "TOLONO",
"state": "IL",
"postal_code": "618800752",
"telephone_number": "765-390-1186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREWER",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-10",
"last_updated": "2024-09-10",
"certification_date": "2024-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178.020550",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tolono, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.