Active NPI
Anthony Brooks
- Counseling Psychologist
- Centralia, IL
National Provider Identifier
1306581103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 180014390
- Practice address
- 8 Edgewood LN N
Centralia, IL 62801-3708 - Phone
- (618) 204-8227
- NPI assigned
- May 5, 2022
- Last updated
- May 5, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 180014390 | IL | Primary |
Addresses
Primary practice location
8 Edgewood LN N
Centralia, IL 62801-3708
Mailing address
8 Edgewood LN N
Centralia, IL 62801-3708
Phone (618) 204-8227
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180014390 | IL | MD | Counseling Psychologist |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651708800000",
"number": "1306581103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 EDGEWOOD LN N",
"city": "CENTRALIA",
"state": "IL",
"postal_code": "628013708",
"telephone_number": "618-204-8227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 EDGEWOOD LN N",
"city": "CENTRALIA",
"state": "IL",
"postal_code": "628013708",
"telephone_number": "618-204-8227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "ANTHONY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-05-05",
"last_updated": "2022-05-05",
"certification_date": "2022-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "IL",
"license": "180014390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centralia, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.