Penny L Brower, PH.D.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

166-000187 Issued in IL

Practice address

4617 N Prospect Rd
Suite 2a
Peoria Heights, IL 61616-6475

Phone

(309) 681-1860

Fax

(309) 681-1871

NPI assigned

Jul 22, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Interoperability endpoints

• Direct secure messaging: lifestancehealth.pennybrower@146897.advancedmd-direct.com

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290556800000",
    "number": "1780605816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4617 N PROSPECT RD",
            "address_2": "SUITE 2A",
            "city": "PEORIA HEIGHTS",
            "state": "IL",
            "postal_code": "616166475",
            "telephone_number": "309-681-1860",
            "fax_number": "309-681-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4617 N PROSPECT RD",
            "address_2": "SUITE 2A",
            "city": "PEORIA HEIGHTS",
            "state": "IL",
            "postal_code": "616166475",
            "telephone_number": "309-681-1860",
            "fax_number": "309-681-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWER",
        "first_name": "PENNY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2010-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-001847",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166-000187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Peoria Heights, IL
• Providers in Peoria Heights, IL by specialty
• Marriage & Family Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; 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.