Active NPI
Jessica Williams, LPC
- Professional Counselor
- Dekalb, IL
National Provider Identifier
1043951908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 178.017437
- Practice address
- 631 S 1St St
Dekalb, IL 60115-4117 - Phone
- (157) 568-5018
- NPI assigned
- Apr 5, 2022
- 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 | 178.017437 | IL | Primary |
Addresses
Primary practice location
631 S 1St St
Dekalb, IL 60115-4117
Mailing address
PO Box 1109
Dekalb, IL 60115-7109
Phone (157) 564-8758
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 474579189001 | Medicaid | IL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
631 S 1St St
Dekalb, IL 60115-4117
Phone (815) 756-8501
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.017437 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dekalb Behavioral Health Foundation, Inc. | Current | Accepting new patients | |
| Dekalb Behavioral Health Foundation, Inc. | Current | Accepting new patients | |
| Dekalb Behavioral Health Foundation, Inc. | Current | Accepting new patients |
Locations
12 Health Services Dr
DeKalb, IL 60115
Phone (815) 756-4875
631 S 1st St
DeKalb, IL 60115
Phone (815) 756-4875
Organizations & group practices 3
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Dekalb, IL
- NPI 1255703450
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Sandwich, IL
- NPI 1316304058
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Sandwich, IL
- NPI 1487015194
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649116800000",
"number": "1043951908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1109",
"city": "DEKALB",
"state": "IL",
"postal_code": "601157109",
"telephone_number": "157-564-8758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "631 S 1ST ST",
"city": "DEKALB",
"state": "IL",
"postal_code": "601154117",
"telephone_number": "157-568-5018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "JESSICA",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-05",
"last_updated": "2022-04-05",
"certification_date": "2022-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178.017437",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "474579189001",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dekalb, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.