Healthcare Provider Details

I. General information

NPI: 1033032859
Provider Name (Legal Business Name): BEACON COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

526 E ALLEN ST
SPRINGFIELD IL
62703-2318
US

IV. Provider business mailing address

40 KIRKLEY LN
SPRINGFIELD IL
62704-5349
US

V. Phone/Fax

Practice location:
  • Phone: 217-415-7207
  • Fax:
Mailing address:
  • Phone: 217-415-7207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: KENNETH ALDEN DUNN JR.
Title or Position: OWNER/MANAGER
Credential: LCPC
Phone: 217-415-7207