Individual provider Active NPI

Wendy Alleen Brown, LCSW

  • Mental Health Counselor
  • Peoria, IL
National Provider Identifier
1215230917
Registry record updated Aug 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
149012160 Issued in IL
Practice address
2000 West Pioneer Parkway
Suite 20
Peoria, IL 61615-5850
Phone
(309) 648-9939
Fax
(309) 692-2052
NPI assigned
Dec 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 149012160 IL Primary
Clinical Social Worker 1041C0700X 149012160 IL

Addresses

Primary practice location

2000 West Pioneer Parkway
Suite 20
Peoria, IL 61615-5850

Mailing address

2000 West Pioneer Parkway
Suite 20
Peoria, IL 61615-5850
Phone (309) 648-9939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140804002397 IL Practitioner - Clinical Social Worker 3577789288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Bloomington, IL 61704
Phone (309) 648-9939

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149012160ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
B & B Counseling Services, LLC Mental Health CurrentSince Jul 22, 2014 Accepting new patients

Locations

2000 W Pioneer Pkwy
Ste 20
Peoria, IL 61615
Phone (309) 648-9939

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1292716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1215230917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 WEST PIONEER PARKWAY",
            "address_2": "SUITE 20",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616155850",
            "telephone_number": "309-648-9939",
            "fax_number": "309-692-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 WEST PIONEER PARKWAY",
            "address_2": "SUITE 20",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616155850",
            "telephone_number": "309-648-9939",
            "fax_number": "309-692-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "WENDY",
        "middle_name": "ALLEEN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-19",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "149012160",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149012160",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.