AMY BRUYN (LCPC) – Professional Counselor, NPI 1366930406

AMY BRUYN (LCPC) is a healthcare provider. based in Rockford, Illinois. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LCPC. They hold a License No. 178-013197 (IL). The NPI Number for AMY BRUYN (LCPC) is 1366930406

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
AMY BRUYN (LCPC)
NPI
1366930406
Phone
(779) 368-0060
Address
6392 LINDEN RD
Enumeration Date
24 April 2018
Last Update Date
24 April 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7793680060
Graduation Year
2010 (16 years ago)
PAC ID
2769925312
Group Practice PAC ID
2163944190
Professional Enrollment ID
I20240624003383
Address ID
IL611092816RO6392XRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

2,307 MENTAL HEALTH COUNSELOR in IL

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Provider Addresses for AMY BRUYN (LCPC)

  • 6392, Linden Road, Rockford, Winnebago County, Illinois, 61109, United States

    ROCKFORD, IL 611092816

    Phone: (779) 368-0060

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-06-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240624003383IMental Health CounselorILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61109)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2163944190View full group profile
NameSpecialtyState
Mental Health CounselorIL
Marriage And Family TherapistIL
Mental Health CounselorIL
Clinical Social WorkerIL
Clinical Social WorkerIL
Mental Health CounselorIL
Clinical Social WorkerIL
Clinical Social WorkerIL
Mental Health CounselorIL
Clinical Social WorkerIL

Reviews

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Frequently asked questions

What is the 10-digit NPI for AMY BRUYN (LCPC)?
AMY BRUYN (LCPC) — NPI 1366930406 — is the standard way to identify this listing.
Can I rely on AMY BRUYN (LCPC) being an active provider?
As of the registry snapshot, AMY BRUYN (LCPC) is marked active.
What healthcare role does AMY BRUYN (LCPC) hold?
Scheduling teams often label AMY BRUYN (LCPC) under Professional Counselor. Clinical services aligned with this taxonomy classification.
What address line appears for AMY BRUYN (LCPC)?
AMY BRUYN (LCPC)'s geographic hint is Rockford, Illinois in our summary view.
Is the information about AMY BRUYN (LCPC) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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