Individual provider Active NPI

Jennifer Ann Morano

  • Counselor
  • Crystal Lake, IL
National Provider Identifier
1033750849
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
180006193 Issued in IL
Practice address
600 Dakota St
Crystal Lake, IL 60012-3742
Phone
(847) 354-5735
NPI assigned
Oct 2, 2019
Last updated
Jul 31, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 180006193 IL Primary

Addresses

Primary practice location

600 Dakota St
Crystal Lake, IL 60012-3742

Mailing address

600 Dakota St
Crystal Lake, IL 60012-3742
Phone (847) 354-5735

Other practice location 1

10793 Oregon Trl
Huntley, IL 60142-4024
Phone (847) 354-5735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240613001177 IL Practitioner - Mental Health Counselor 3476095860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blair Counseling and Mediation PCGroup PAC ID 9032515796, 4 clinicians

Practice addresses (Care Compare)

600 Dakota St
Suite B
Crystal Lake, IL 60012-3742
Phone (815) 276-3947

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180006193ILMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Blair Counseling and Mediation PC Single Specialty CurrentSince Apr 1, 2024 Accepting new patients

Locations

600 Dakota St
Ste B
Crystal Lake, IL 60012
Phone (815) 276-3947

12555 Farm Hill Dr
Ste 500
Huntley, IL 60142
Phone (901) 205-9395

Organizations & group practices 1

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": "1569974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1033750849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 DAKOTA ST",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600123742",
            "telephone_number": "847-354-5735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 DAKOTA ST",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600123742",
            "telephone_number": "847-354-5735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10793 Oregon Trl",
            "address_purpose": "LOCATION",
            "city": "Huntley",
            "state": "IL",
            "postal_code": "601424024",
            "country_code": "US",
            "telephone_number": "847-354-5735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORANO",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-02",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180006193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.