Jennifer Scully, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180008794 Issued in IL

Practice address

49 Fairway Ter
Winchester, TN 37398-2421

Phone

(708) 695-4882

Fax

(888) 494-1984

NPI assigned

Oct 6, 2013

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1381017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1013344050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 FAIRWAY TER",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373982421",
            "telephone_number": "708-695-4882",
            "fax_number": "888-494-1984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 FAIRWAY TER",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373982421",
            "telephone_number": "708-695-4882",
            "fax_number": "888-494-1984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCULLY",
        "first_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-06",
        "last_updated": "2022-08-22",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180008794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://rewiredtraumahealing.com/",
            "affiliation": "N",
            "address_1": "49 Fairway Ter",
            "city": "Winchester",
            "state": "TN",
            "country_code": "US",
            "postal_code": "373982421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joel Sanderson
• Rene Christine Saunders, M.D.
• Regina Sawyer
• Yalda Alina Sayed
• Bradley Devon Schapiro, D.C.
• Sarah Seagroves, M.S., CCC-SLP
• Felicia Sells
• Clint W Selvage, FNP
• Cheryl Shedd
• Michael Shenkman, MD

• Mental Health Counselor in Winchester, TN
• Providers in Winchester, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.