Donna C Bredrup, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180005131 Issued in IL

Practice address

4300 Commerce CT Ste 300-9
Lisle, IL 60532-3709

Phone

(630) 791-7117

NPI assigned

Nov 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 11, 2024 through Jan 11, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Past Present Future

  • Mental Health Counselor
  • Lisle, IL
  • NPI 1952904468
  NPD Authorized official
• Quest Clinical Services, LTD.

  • Mental Health Counselor
  • Lisle, IL
  • NPI 1609950088
  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1902970833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4832 WALLBANK AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605153404",
            "telephone_number": "630-263-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 COMMERCE CT STE 300-9",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323709",
            "telephone_number": "630-791-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREDRUP",
        "first_name": "DONNA",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180005131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Boyce Chiropractic Lisle
• Jennifer Lauren Brammeier, D.D.S
• Marc I Brand, M.D.
• Steven Benjamin Brandes, M.D.
• Christina E Bratis, M.D.
• Margaret Mary Brennan
• Sandra Broaddus, H.I.S.
• Matt Brodie, ATC
• John Lowell Brom, MSW, LCSW
• Audrey A Bromberger, MD

• Mental Health Counselor in Lisle, IL
• Providers in Lisle, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.