Laura Jackman

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

180.003361 Issued in IL

Practice address

1415 Maple Rd
Joliet, IL 60432-1442

Phone

(815) 735-0732

NPI assigned

Oct 5, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Kennedy Center for Counseling, P.C.Group PAC ID 5496052656, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Kennedy Center for Counseling, P.C.

  • Mental Health Counselor
  • New Lenox, IL
  • NPI 1538569058
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1223164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223164800000",
    "number": "1003067307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 LAMBETH LN",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 MAPLE RD",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604321442",
            "telephone_number": "815-735-0732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKMAN",
        "first_name": "LAURA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-05",
        "last_updated": "2008-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "180.003361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J D Brown & Co Inc
• J D Brown & Co Inc
• J.E. Bertolini MD, S.C.
• J.E.Bertolini ,M.D. SC.
• Nabil Jaber, MD
• Michael Jacksa, LCPC
• Jessica Jackson, PA-C
• Kennedi D Jackson
• Keri Alyse Jackson
• Shea Lynn Jacobs

• Clinical Psychologist in Joliet, IL
• Providers in Joliet, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.