Beacon of Enlightenment

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

BEACON OF ENLIGHTENMENT

Practice address

6072 Brynwood Dr Ste 201
Rockford, IL 61114-5829

Phone

(815) 564-8633

Fax

(779) 423-0778

NPI assigned

Nov 22, 2021

Organization subpart

No

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

Authorized official

Name

Crisy Gowan, LCPCNPI 1831420603

Title

Owner

Phone

(815) 564-8633

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Latavia Shantaye Agada, MA, LCSW

  • Clinical Social Worker
  • Rockford, IL
  • NPI 1417338799

  IL

  Medicare reassignment NPD
• Alexandria Joann Hummel

  • Clinical Social Worker
  • Crystal Lake, IL
  • NPI 1487134979

  IL

  Medicare reassignment NPD
• Crisy Gowan

  • Mental Health Counselor
  • Crystal Lake, IL
  • NPI 1831420603
  NPD Authorized official

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744588800000",
    "number": "1376200550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 COVENTRY LN STE 100",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147589",
            "telephone_number": "815-564-8633",
            "fax_number": "779-423-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6072 BRYNWOOD DR STE 201",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611145829",
            "telephone_number": "815-564-8633",
            "fax_number": "779-423-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON OF ENLIGHTENMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-22",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A",
        "authorized_official_last_name": "GOWAN",
        "authorized_official_first_name": "CRISY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-564-8633",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul R Batty, MD
• Sasha Atira Bauer, MS
• Bradley Bauman, ATC
• Susan J Baumgarth-Williams, COTA
• Ashley Baylor, LCPC
• Kathryn V Beam, AUD
• Justine Lyn Beaman, FNP-BC
• Stephen Douglas Beaman, LCSW
• Brigid Bean, FNP-C
• Brian J Bear, MD

• All providers in Rockford, IL
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.