Healthcare Provider Details

I. General information

NPI: 1376447169
Provider Name (Legal Business Name): AMY ENGLE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4505 N ILLINOIS ST STE 1
SWANSEA IL
62226-1500
US

IV. Provider business mailing address

2146 SOUTHERN OAK CIR
BELLEVILLE IL
62226-6930
US

V. Phone/Fax

Practice location:
  • Phone: 618-416-0840
  • Fax:
Mailing address:
  • Phone: 618-416-0840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.033501
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: