Provider Demographics
NPI:1629530563
Name:BILSON, AMIE J (LPC, RN)
Entity Type:Individual
Prefix:
First Name:AMIE
Middle Name:J
Last Name:BILSON
Suffix:
Gender:F
Credentials:LPC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3909 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-2218
Mailing Address - Country:US
Mailing Address - Phone:412-638-7190
Mailing Address - Fax:
Practice Address - Street 1:1147 W OHIO ST STE 103
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-5874
Practice Address - Country:US
Practice Address - Phone:312-772-9796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
IL041374632163WC1500X
IL178013492101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health