Individual provider Active NPI

Rachel Burns

  • Professional Counselor
  • Maryville, IL
National Provider Identifier
1699390377
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.015150 Issued in IL
Practice address
9 Professional Park Dr # 16B
Maryville, IL 62062-5672
Phone
(419) 953-1259
NPI assigned
Jun 9, 2020
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Professional Counselor 101YP2500X 180.015150 IL Primary

Addresses

Primary practice location

9 Professional Park Dr # 16B
Maryville, IL 62062-5672

Mailing address

9 Professional Park Dr # 16B
Maryville, IL 62062-5672

Other practice location 1

3008 Happy Landing Dr
Springfield, IL 62711-6259
Phone (630) 428-7890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
180.015150ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Priority Counseling LLC Mental Health Current Accepting new patients
Edgewood Clinical Services, P.C. Mental Health CurrentSince Jul 26, 2023 Accepting new patients
Therapeutic, Education, and Career Services, Inc. Counselor PastSince Jun 1, 2020 Accepting new patients

Locations

3008 Happy Landing Dr
Springfield, IL 62711
Phone (217) 523-4534

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1699390377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 PROFESSIONAL PARK DR # 16B",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 PROFESSIONAL PARK DR # 16B",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625672",
            "telephone_number": "419-953-1259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3008 Happy Landing Dr",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627116259",
            "country_code": "US",
            "telephone_number": "630-428-7890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNS",
        "first_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-09",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.015150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.