Jennifer R Young, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

31 W 155TH St
Harvey, IL 60426-3556

Phone

(708) 596-5177

Fax

(708) 596-5518

NPI assigned

Nov 17, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jennifer R Agnew Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• With Grace Counseling and Consulting International, PLLC

  • Marriage & Family Therapist
  • Chicago Heights, IL
  • NPI 1831928449
  NPD Authorized official

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

{
    "created_epoch": "1668643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1053020107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 W 155TH ST",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263556",
            "telephone_number": "708-596-5177",
            "fax_number": "708-596-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 W 155TH ST",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263556",
            "telephone_number": "708-596-5177",
            "fax_number": "708-596-5518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-17",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178017195",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "AGNEW",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa K Wright, M.D.
• Zachary Wright, M.D.
• Sulochana D Yalavarthi, M.D.
• Jeffrey Yeh, M.D.
• Engin Yilmaz, MD
• Nausheen Zufishan, MD
• Judith Lee Zwierz, M.H.S.
• ZZM Investments Inc

• Counselor in Harvey, IL
• Providers in Harvey, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.