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BRENDA I BEANBLOSSOM, MA LCPC – NPI #1669674214
Professional

NPI Profile for BRENDA I BEANBLOSSOM in CARLINVILLE, IL.

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Contact Information

BRENDA I BEANBLOSSOM, MA LCPC
320 SOUTH LOCUST STREET
CARLINVILLE, IL  62626
 Phone: 217-854-3166
 Fax: 217-854-9729
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Professional

 101YP2500X
Indicates primary specialty

NPI Profile & details for BRENDA I BEANBLOSSOM · (Female)

NPI Number 1669674214
Status Active
Credentials MA LCPC
Entity Individual
Enumeration date 06/05/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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