Audrey Burris
Individual provider Active NPI Mental Health Counselor · Oswego, IL
NPI 1689350704 · NPPES record last updated Oct 12, 2023
Key facts
- NPI
- 1689350704
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 412 Sudbury Cir
Oswego, IL 60543-7149 - Phone
- (630) 362-5979
- NPI assigned
- Jun 23, 2023
- Sex
- Female
- Sole proprietor
- No
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Superhero Behavior LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes | ||
| Behavior Technician | 106S00000X |
Addresses
Primary practice location
412 Sudbury Cir
Oswego, IL 60543-7149
Mailing address
412 Sudbury Cir
Oswego, IL 60543-7149
Phone (630) 362-5979
Other providers in Oswego, IL
- Sherry Lee Bryant
- Kristin Michelle Buddin
- Julia A Burban
- Mindy Burkhamer
- Stephanie Burl
- Moreen L Butterworth
- Marsha Molnar Buvary
- Lauren Faith Buzzard
- Gretchen M Byrd
- Kristy Cahill
All providers in Oswego, IL · Mental Health 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 Oct 12, 2023. 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.