Jennifer Carleton, LPC – Professional Counselor

Key facts

NPI: 1003530395
Entity type: Individual (NPI type 1)
Primary specialty: Professional Counselor 101YP2500X
License: 178018284 (IL)
Practice address: 411 Devonshire Dr
Champaign, IL 61820-7286
Phone: (217) 904-3035
NPI assigned: Sep 29, 2022
Sex: Female
Sole proprietor: No

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 and National Provider Directory roles.

Kendrick Counseling, PLLC Marriage & Family Therapist · Champaign, IL · NPI 1225612872

NPD (past)
Symatree LLC Psychiatric/Mental Health Nurse Practitioner · Champaign, IL · NPI 1790496099

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
178018284	IL	MD	Professional Counselor

Practice roles

Organization	Specialty	Status	New patients
Kendrick Counseling, PLLC		Past	Accepting new patients
Symatree LLC		Past since Dec 28, 2022	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Professional Counselor	101YP2500X	178018284	IL	Yes

Addresses

Primary practice location

411 Devonshire Dr
Champaign, IL 61820-7286

Mailing address

411 Devonshire Dr
Champaign, IL 61820-7286
Phone (217) 904-3035

Other providers in Champaign, IL

All providers in Champaign, IL · Professional Counselor in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.