Amanda R Weber, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209031040 Issued in IL

Practice address

322 S Buchanan St
Edwardsville, IL 62025-2086

Phone

(618) 967-0518

Fax

(618) 417-6049

NPI assigned

Nov 13, 2024

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

Practice roles

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.

• Koen Counseling and Wellness Center

  • Mental Health Counselor
  • Herrin, IL
  • NPI 1952050460
  NPD (past)

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1417771692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6856 MIDDLEGATE LN",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620344053",
            "telephone_number": "314-570-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 S BUCHANAN ST",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620252086",
            "telephone_number": "618-967-0518",
            "fax_number": "618-417-6049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "AMANDA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-13",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209031040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dane C Wallace, NURSE PRACTITIONER
• Tammy Lynn Walls
• Jordan Boyer Walters
• Taletta Ann Watson, D.M.D.
• Angela Marie Watters, M.S., CCC-SLP
• Timothy David Weddle, RN
• Wee Movers Therapy Services
• Haley Marie Wehrs, RN
• Amanda Brittany Weiss, NP
• Christy Weiss, NP

• Psychiatric/Mental Health Nurse Practitioner in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.