Andrea Lynn Shryock, L.C.P.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180-006626 Issued in IL

Practice address

128 Washington SQ
Washington, IL 61571-2657

Phone

(800) 773-1682

NPI assigned

Sep 27, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Skill Sprout, LLC

  • Behavior Analyst
  • Washington, IL
  • NPI 1659600948
  NPD (past)

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1194152769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKEYE WAY",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627075722",
            "telephone_number": "217-415-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 WASHINGTON SQ",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615712657",
            "telephone_number": "800-773-1682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRYOCK",
        "first_name": "ANDREA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "L.C.P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-27",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-006626",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178-003130",
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "IL",
            "license": "228311",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Seger, PTA
• Barbara Selden, M.S.
• Shelly Shallat
• Marcy Short, SLP
• Christina Showalter
• Glen J Sidler, M.D.
• Skill Sprout
• Skill Sprout Diagnostic
• Skill Sprout International
• Skill Sprout, LLC

• Professional Counselor in Washington, IL
• Providers in Washington, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; 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.