Avery Marie Braunecker, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

150104070 Issued in IL

Practice address

1001 Ford Ave
Effingham, IL 62401-1701

Phone

(217) 347-6700

NPI assigned

Oct 18, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1316729858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 PARK HILLS DR",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624013151",
            "telephone_number": "217-343-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 FORD AVE",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624011701",
            "telephone_number": "217-347-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUNECKER",
        "first_name": "AVERY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-18",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150104070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Effingham, IL
• Providers in Effingham, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.