Bethany Vanne, L.C.P.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180.008327 Issued in IL

Practice address

3716 W Brighton Ave
Peoria, IL 61615-2938

Phone

(309) 692-7755

Fax

(309) 692-2262

NPI assigned

Aug 13, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• John Day & Associates, LTD

  • Clinical Psychologist
  • Peoria, IL
  • NPI 1245454313
  NPD (past)

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344902400000",
    "number": "1942557525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3716 W BRIGHTON AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152938",
            "telephone_number": "309-692-7755",
            "fax_number": "309-692-2262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3716 W BRIGHTON AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152938",
            "telephone_number": "309-692-7755",
            "fax_number": "309-692-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNE",
        "first_name": "BETHANY",
        "credential": "L.C.P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-13",
        "last_updated": "2012-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.008327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI - GROUP - JOHN R. DAY AND ASSOCIATES",
            "identifier": "1245454313",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEIN - TAX IDENTIFICATION NUMBER FOR EMPLOYER",
            "identifier": "371154942",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE, PTAN",
            "identifier": "366380",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori Van Vooren
• Caroline Vanaman
• Clark O Vandegraft, PTA
• Aaron Thomas Vangeest
• Heidi M Vanheuklon, LCPC
• Holly Vannitamby, DO
• Martin Varela, OD
• Scot L Varness, D.C.
• Elsa L Vazquez Melendez, MD
• Michael H Veeder, MD

• Mental Health Counselor in Peoria, IL
• Providers in Peoria, 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 Aug 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.