Provider Demographics
NPI:1992392336
Name:BRENDA SOMMER THERAPY & CONSULTING, LLC
Entity Type:Organization
Organization Name:BRENDA SOMMER THERAPY & CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCPC
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOMMER
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:309-531-8945
Mailing Address - Street 1:1801 WOODFIELD DR # 207
Mailing Address - Street 2:
Mailing Address - City:SAVOY
Mailing Address - State:IL
Mailing Address - Zip Code:61874-9505
Mailing Address - Country:US
Mailing Address - Phone:309-531-8945
Mailing Address - Fax:217-954-9292
Practice Address - Street 1:1801 WOODFIELD DR # 207
Practice Address - Street 2:
Practice Address - City:SAVOY
Practice Address - State:IL
Practice Address - Zip Code:61874-9505
Practice Address - Country:US
Practice Address - Phone:309-531-8945
Practice Address - Fax:217-954-9292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL180.009098OtherLICENSE NUMBER