Amanda Breeden Counseling Services LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

AMANDA BREEDEN COUNSELING SERVICES LLC

Practice address

5901 N Prospect Rd Ste 105
Peoria, IL 61614-4358

Phone

(309) 340-1363

Fax

(309) 417-7719

NPI assigned

Apr 27, 2020

Last updated

Apr 27, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amanda Fay Breeden, LCPCNPI 1669851705

Title

Therapist/Owner

Phone

(309) 340-1363

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amanda Breeden, LCPC

  • Mental Health Counselor
  • Peoria, IL
  • NPI 1669851705
  NPD Authorized official

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587945600000",
    "number": "1447871827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 N PROSPECT RD STE 105",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144358",
            "telephone_number": "309-340-1363",
            "fax_number": "309-417-7719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 N PROSPECT RD STE 105",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144358",
            "telephone_number": "309-340-1363",
            "fax_number": "309-417-7719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMANDA BREEDEN COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-27",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A",
        "authorized_official_last_name": "BREEDEN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "FAY",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "309-340-1363",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Peoria, IL
• Providers in Peoria, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; 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.