Jessie Shanks Counseling, Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

JESSIE SHANKS COUNSELING, INC.

Practice address

514 Broadway St Unit 1351
Pekin, IL 61555-2260

Phone

(309) 322-2900

Fax

(309) 322-2901

NPI assigned

Sep 4, 2024

Organization subpart

No

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

Authorized official

Name

Jessie Shanks, LMHC, LCPCNPI 1881105807

Title

Owner

Phone

(309) 322-2900

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessie Shanks, LMHC, LCPC

  • Mental Health Counselor
  • Pekin, IL
  • NPI 1881105807
  NPD Authorized official

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

{
    "created_epoch": "1725408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725408000000",
    "number": "1013742519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 AUGUSTA ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615543002",
            "telephone_number": "309-322-2900",
            "fax_number": "309-322-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 BROADWAY ST UNIT 1351",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615552260",
            "telephone_number": "309-322-2900",
            "fax_number": "309-322-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSIE SHANKS COUNSELING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-04",
        "last_updated": "2024-09-04",
        "certification_date": "2024-08-24",
        "status": "A",
        "authorized_official_last_name": "SHANKS",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-322-2900",
        "authorized_official_credential": "LMHC, LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Pekin, IL
• Providers in Pekin, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.