Individual provider Active NPI

Breana Renee Willoughby, SLP

  • Speech-Language Pathologist
  • Amarillo, TX
National Provider Identifier
1962867481
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
111384 Issued in TX
Practice address
1600 S Coulter St BLDG D
Amarillo, TX 79106-1839
Phone
(806) 468-7611
Fax
(806) 468-7603
NPI assigned
Dec 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 111384 TX Primary

Addresses

Primary practice location

1600 S Coulter St BLDG D
Amarillo, TX 79106-1839

Mailing address

1600 S Coulter St BLDG D
Amarillo, TX 79106-1839
Phone (806) 468-7611

Other names 1

  • Breana Willoughby Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
111384TXMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1451260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1962867481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S COULTER ST BLDG D",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061839",
            "telephone_number": "806-468-7611",
            "fax_number": "806-468-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S COULTER ST BLDG D",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061839",
            "telephone_number": "806-468-7611",
            "fax_number": "806-468-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLOUGHBY",
        "first_name": "BREANA",
        "middle_name": "RENEE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-28",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "111384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BREANA",
            "last_name": "WILLOUGHBY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; 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.