BETHANY VANNE (NPI# 1942557525) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942557525 |
| Entity Type | Individual |
| Full Name | BETHANY VANNE |
| Credential | L.C.P.C. |
| Practice Address |
3716 W Brighton Ave Peoria IL 61615-2938 |
| Practice Telephone | 3096927755 |
| Practice Fax Number | 3096922262 |
| Mailing Telephone | 3096927755 |
| Mailing Fax Number | 3096922262 |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2012-08-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
180.008327 | IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | NPI - GROUP - JOHN R. DAY AND ASSOCIATES | 1245454313 | 01 |
| IL | MEDICARE, PTAN | 366380 | 01 |
| IL | TEIN - TAX IDENTIFICATION NUMBER FOR EMPLOYER | 371154942 | 01 |
| Street Address |
3716 W BRIGHTON AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61615-2938 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568434306 | Sarah Katherine Holland | Counselor | 3716 W Brighton Ave, Peoria, IL 61615-2938 | 2006-02-06 |
| 1427612464 | Morris Daniel Lee | Counselor | 3716 W Brighton Ave, Peoria, IL 61615-2938 | 2019-04-25 |
| 1467802090 | Jennifer Morrison | Counselor | 3716 W Brighton Ave, Peoria, IL 61615-2938 | 2016-06-14 |
| 1780973925 | Mikell Ryanne Ehnle | Psychologist | 3716 W Brighton Ave, Peoria, IL 61615-2938 | 2011-03-28 |
| 1861699472 | David Christopher Weidner | Psychologist | 3716 W Brighton Ave, Peoria, IL 61615-2938 | 2007-06-27 |
| 1568689511 | Ruth Ann Jennings | Social Worker | 3716 W Brighton Ave, Peoria, IL 61615-2938 | 2007-04-19 |
| 1326199407 | Jacqueline Lee Clemons | Social Worker | 3716 W Brighton Ave, Peoria, IL 61615-2938 | 2007-01-15 |
| 1013974765 | John Richard Day | Psychologist | 3716 W Brighton Ave, Peoria, IL 61615 | 2006-04-27 |
| 1255396347 | Phillip J Ladd | Counselor | 3716 W Brighton Ave, Peoria, IL 61615 | 2006-04-20 |
| 1013972082 | Donna Jaree Brooks | Counselor | 3716 W Brighton Ave, Peoria, IL 61615-2938 | 2006-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627906 | Lance Jay Bucher | Occupational Therapist | 8600 Il-91, Peoria, IL 61615 | 2020-10-22 |
| 1093327496 | Angela Mitchell | Speech-Language Pathologist | 3903 W Ridgeview Dr, Peoria, IL 61615 | 2020-08-18 |
| 1578110680 | Emily E Buenting | Audiologist | 8600 Il Route 91, Suite 300, Peoria, IL 61615 | 2019-08-22 |
| 1730655572 | Sylwia M. Budzik | Physician Assistant | 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 | 2018-10-19 |
| 1487169207 | Heather Hart | Registered Nurse | 9016 N. Scrimshaw Dr. Apt 104, Peoria, IL 61615 | 2017-12-04 |
| 1528586849 | Leanne Runyon | Speech-Language Pathologist | 10723 Collett Dr., Peoria, IL 61615 | 2017-09-07 |
| 1467974196 | Elizabeth A Mcleod | Nurse Practitioner | 8600 Illinois Route 91, Suite 130, Peoria, IL 61615 | 2017-07-14 |
| 1790223022 | Janet Warner | Counselor | 8914 North Prarie Court, Peoria, IL 61615 | 2017-02-07 |
| 1437524022 | Brooke Bisping | Dietitian, Registered | 7610 North Orange Prairie Road, Peoria, IL 61615 | 2015-12-08 |
| 1003292111 | Crystal Ann Casper | Dietitian, Registered | 7610 N Orange Prarie Road, Peoria, IL 61615 | 2015-07-31 |
| Find all providers in zip 61615 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487254629 | Bernadette Bruha | Counselor | 10028 W Redbird Rd, Peoria, AZ 85383-3368 | 2020-10-27 |
| 1063020071 | Pschertz Counseling | Counselor | 5016 N University St Ste 101, Peoria, IL 61614-4763 | 2020-07-15 |
| 1427674902 | Centerpoint Counseling Associates LLC | Counselor | 7820 N University St Ste 102b, Peoria, IL 61614-1220 | 2020-06-22 |
| 1962032938 | Sheri Orr | Counselor | 8401 W Desert Elm Ln, Peoria, AZ 85383-3645 | 2020-01-18 |
| 1952958050 | Emily Louise Trulson | Counselor | 3526 N California Ave, Peoria, IL 61603-1168 | 2019-08-22 |
| 1518441997 | Jill Johnson | Counselor | 29267 N 123rd Dr, Peoria, AZ 85383-4074 | 2018-09-20 |
| 1407359367 | Lori Bushell Counseling LLC | Counselor | 2000 W Pioneer Pkwy Ste 20, Peoria, IL 61615-5805 | 2018-03-16 |
| 1114427952 | Jessica Anne Hunter | Counselor | 10184 W Happy Valley Rd Ste 190, Peoria, AZ 85383-1254 | 2018-02-19 |
| 1881101806 | Michelle Elizabeth Juslin | Counselor | 8530 W Caribbean Ln, Peoria, AZ 85381-3531 | 2017-12-29 |
| 1235672973 | Amy N Kelch | Counselor | 4228 N University St, Peoria, IL 61614-6913 | 2016-11-29 |
| Find all providers in PEORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.