Active NPI
Jodi Kay Walsh, MA LCPC
- Professional Counselor
- Homer Glen, IL
National Provider Identifier
1033377320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180006903
- Practice address
- 15915 S Crystal Creek Drive
Unit E
Homer Glen, IL 60491-9284 - Phone
- (708) 334-7711
- NPI assigned
- May 23, 2008
- Last updated
- May 23, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180006903 | IL | Primary |
Addresses
Primary practice location
15915 S Crystal Creek Drive
Unit E
Homer Glen, IL 60491-9284
Mailing address
15915 S Crystal Creek Dr
Unit E
Homer Glen, IL 60491-9284
Phone (708) 334-7711
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180006903 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211500800000",
"number": "1033377320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15915 S CRYSTAL CREEK DR",
"address_2": "UNIT E",
"city": "HOMER GLEN",
"state": "IL",
"postal_code": "604919284",
"telephone_number": "708-334-7711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15915 S CRYSTAL CREEK DRIVE",
"address_2": "UNIT E",
"city": "HOMER GLEN",
"state": "IL",
"postal_code": "604919284",
"telephone_number": "708-334-7711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSH",
"first_name": "JODI",
"middle_name": "KAY",
"credential": "MA LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-23",
"last_updated": "2008-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180006903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Homer Glen, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.