Active NPI
Patricia Breshears
- Professional Counselor
- Alton, IL
National Provider Identifier
1215330766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180.004916
- Practice address
- 108 Northport Dr
Alton, IL 62002-5904 - Phone
- (618) 466-0295
- Fax
- (618) 551-2676
- NPI assigned
- Sep 29, 2014
- Sex
- Female
- Sole proprietor
- No
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 | 180.004916 | IL | Primary |
Addresses
Primary practice location
108 Northport Dr
Alton, IL 62002-5904
Mailing address
108 Northport Dr
Alton, IL 62002-5904
Phone (618) 466-0295
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
108 Northport Dr
Alton, IL 62002-5904
Phone (618) 466-0295
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180.004916 | IL | MD | Professional Counselor |
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.
-
- Professional Counselor
- Alton, IL
- NPI 1134505829
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782777600000",
"number": "1215330766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 NORTHPORT DR",
"city": "ALTON",
"state": "IL",
"postal_code": "620025904",
"telephone_number": "618-466-0295",
"fax_number": "618-551-2676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 NORTHPORT DR",
"city": "ALTON",
"state": "IL",
"postal_code": "620025904",
"telephone_number": "618-466-0295",
"fax_number": "618-551-2676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRESHEARS",
"first_name": "PATRICIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-29",
"last_updated": "2026-06-30",
"certification_date": "2026-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180.004916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.