Individual provider Active NPI

Jodi M. Walker, MA

  • Mental Health Counselor
  • Pevely, MO
National Provider Identifier
1003330630
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2026011556 Issued in MO
Practice address
925 Creekview CT
Pevely, MO 63070-2985
Phone
(636) 232-1558
NPI assigned
Jul 25, 2017
Last updated
Apr 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2026011556 MO Primary
Counselor 101Y00000X

Addresses

Primary practice location

925 Creekview CT
Pevely, MO 63070-2985

Mailing address

1003 Martin Luther King Dr
Bloomington, IL 61701-1429
Phone (888) 924-3786

Other practice location 1

102 4th St
Hillsboro, MO 63050-5043
Phone (618) 877-4420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20231202000678 MO Practitioner - Mental Health Counselor 6002264959 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2026011556MOMDMental Health Counselor
2015032006MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Chestnut Health Systems Inc. CurrentSince Jan 1, 2024 Accepting new patients
Chestnut Health Systems Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

1003 Martin Luther King Dr
Bloomington, IL 61701
Phone (309) 827-6026

448 Wylie Dr
Normal, IL 61761
Phone (844) 973-6887

102 4th St
Hillsboro, MO 63050
Phone (636) 638-2618

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1003330630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 MARTIN LUTHER KING DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617011429",
            "telephone_number": "888-924-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CREEKVIEW CT",
            "city": "PEVELY",
            "state": "MO",
            "postal_code": "630702985",
            "telephone_number": "636-232-1558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 4th St",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "MO",
            "postal_code": "630505043",
            "country_code": "US",
            "telephone_number": "618-877-4420",
            "fax_number": "618-877-4420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "JODI",
        "middle_name": "M.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2026011556",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pevely, MO

Sources for this page

Verify at the official NPI Registry.