Provider Demographics
NPI:1568244556
Name:ANDERSON, BRIANNA (MA, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:MRS
Other - First Name:BRIANNA
Other - Middle Name:
Other - Last Name:KASSEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4951 BODE LN
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-6600
Mailing Address - Country:US
Mailing Address - Phone:224-629-9869
Mailing Address - Fax:
Practice Address - Street 1:1457 MERCHANT DR
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-5917
Practice Address - Country:US
Practice Address - Phone:847-461-8414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-16
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.019440101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health