Amanda Benson, M.A., LCPC
Individual provider Active NPI Professional Counselor · Shiloh, IL
NPI 1467838151 · NPPES record last updated Aug 4, 2015
Key facts
- NPI
- 1467838151
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 180.008106 (IL)
- Practice address
- 1161 Fortune Blvd
Suite 400
Shiloh, IL 62269-7385 - Phone
- (618) 830-8146
- Fax
- (618) 206-8476
- NPI assigned
- Aug 4, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180.008106 | IL | MD | Professional Counselor |
| 2009032848 | MO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amanda Benson Counseling, LLC | Professional | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180.008106 | IL | Yes |
| Professional Counselor | 101YP2500X | 2009032848 | MO |
Addresses
Primary practice location
1161 Fortune Blvd
Suite 400
Shiloh, IL 62269-7385
Mailing address
912 Monterey Dr
O Fallon, IL 62269-2833
Phone (618) 830-8146
Other providers in Shiloh, IL
- Muhammad Farooq Asghar
- Kevin T Barnett
- Lisa Noelle Becker
- Barbara Beckley
- Behavior Consulting, LLC
- Michael A Bergom
- Caitlin Jean Besand
- Mia Bilotti-Garmon
- Biovision Clinical LLC
- Evan Blankenship
All providers in Shiloh, IL · Professional Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.