Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

BREANNA LOGAN MANK
NPI 1104547702
Psychologist - School in Red Bud, IL

Active since September 12, 2022
1525 LOCUST ST, RED BUD, IL 62278(618) 282-6251 Get Directions Write a Review

NPPES record last updated: August 25, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Aug 25, 2026, Sep 12, 2022 (2 updates tracked since 2022).

About Breanna Logan Mank NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BREANNA LOGAN MANK (NPI 1104547702) is an individual school provider in Red Bud, Illinois, licensed in Illinois (1383039) and active in the NPI registry since September 2022.

NPPES Registry Identity

NPI1104547702
Entity TypeIndividualFemale
Primary Taxonomy103TS0200X
Provider Legal NameBREANNA LOGAN MANK
Location Address1525 LOCUST STRed Bud, IL 62278-1374
Mailing Address605 S Benton StNew Athens, IL 62264-1608 · (618) 550-9969
Sole ProprietorNo
Enumeration DateSeptember 12, 2022
Last NPPES UpdateAugust 25, 20262 updates tracked since enumeration
NPPES CertifiedAugust 25, 2026
NPI 1104547702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologist · SchoolBehavioral Health & Social Service Providers
Taxonomy Code103TS0200X
License Licensed in IL · 1383039
Definition
A psychologist whose specialty is concerned with the science and practice of psychology with children, youth, families; learners of all ages; and the schooling process. The basic education and training of school psychologists prepares them to provide a range of psychological diagnosis, assessment, intervention, prevention, health promotion, and program development and evaluation services with a special focus on the developmental processes of children and youth within the context of schools, families and other systems. School psychologists are prepared to intervene at the individual and system level, and develop, implement, and evaluate preventive programs. In these efforts, they conduct ecologically valid assessments and intervene to promote positive learning environments within which children and youth from diverse backgrounds to ensure that all have equal access to effective educational and psychological services that promote healthy development
1525 LOCUST ST, Red Bud, IL 62278

Other Names 1

Former Name (1)Breanna Logan Clubb

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist (School)
1525 LOCUST ST
RED BUD, IL 62278
Psychologist (School)
1525 LOCUST ST
RED BUD, IL 62278
Psychologist (School)
1525 LOCUST ST
RED BUD, IL 62278
Psychologist (School)
1525 LOCUST ST
RED BUD, IL 62278
Psychologist (School)
1525 LOCUST ST
RED BUD, IL 62278
Speech-Language Pathologist
1525 LOCUST ST
RED BUD, IL 62278
Psychologist (School)
1525 LOCUST ST
RED BUD, IL 62278
Occupational Therapist
1525 LOCUST ST
RED BUD, IL 62278

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Breanna Mank's NPI number?

The NPI number for Breanna Mank is 1104547702. It was assigned to this individual provider in the NPPES registry on September 12, 2022. The provider is also known as Breanna Logan Clubb.

Where is Breanna Mank located?

Breanna Mank practices at 1525 Locust St, Red Bud, IL 62278. The listed phone number is (618) 282-6251.

What is Breanna Mank's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in School, with taxonomy code 103TS0200X.

When was this NPI record last updated?

The NPPES record for Breanna Mank was last updated on August 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 26 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.