Organization Active NPI

Guided Healing

  • Professional Counselor
  • Maryville, IL
National Provider Identifier
1760064489
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
GUIDED HEALING
Practice address
6209 E Main St
Maryville, IL 62062-2015
Phone
(618) 917-4207
NPI assigned
Apr 22, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Authorized official

Name
Mrs. Andilyn Burgess, LCPCNPI 1992105480
Title
Psychotherapist
Phone
(618) 917-4207

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

6209 E Main St
Maryville, IL 62062-2015

Mailing address

343 Moultrie LN
O Fallon, IL 62269-7174
Phone (618) 917-4207

Other names 1

  • Guided Healing Other name

National Provider Directory

National Provider Directory

Locations

6209 E Main St
Maryville, IL 62062
Phone (618) 917-4207

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1760064489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 MOULTRIE LN",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622697174",
            "telephone_number": "618-917-4207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6209 E MAIN ST",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620622015",
            "telephone_number": "618-917-4207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUIDED HEALING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "BURGESS",
        "authorized_official_first_name": "ANDILYN",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "618-917-4207",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Guided Healing",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Apr 22, 2021; 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.