Amanda Stasiewicz
Individual provider Active NPI Mental Health Counselor · Dekalb, IL
NPI 1871007989 · NPPES record last updated Nov 28, 2017
Key facts
- NPI
- 1871007989
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 507 E Taylor St
Dekalb, IL 60115-4573 - Phone
- (815) 206-9055
- NPI assigned
- Nov 28, 2017
- 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 |
|---|---|---|---|
| Association for Individual Development | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
507 E Taylor St
Dekalb, IL 60115-4573
Mailing address
507 E Taylor St
Dekalb, IL 60115-4573
Other providers in Dekalb, IL
- Aparna Srinivasa
- Jasmine Alexis Sronkoski
- Amberly Stallard
- Denise Stanbery
- Daniel E Stasi
- Mariah Grace Steffen-Merlo
- Paula June Steimel
- Elizabeth Ann Stephenson
- Stewart Family Chiropractic LLC
- Elizabeth Anderson Stewart
All providers in Dekalb, 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 Nov 28, 2017. 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.