Jane Addams

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

JANE ADDAMS

Doing business as

FHN Family Counseling Center

Practice address

3001 Highland View Dr
Freeport, IL 61032-6942

Phone

(815) 599-7300

NPI assigned

Sep 4, 2020

Last updated

Sep 4, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

JANE ADDAMS COMMUNITY MENTAL HEALTH CENTERAs reported in NPPES

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

Authorized official

Name

Ashley Anne Mazzarisi

Title

Provider Enrollment

Phone

(815) 599-7935

Specialties & licenses 1

Addresses

Other names 1

• FHN Family Counseling Center Doing business as

Tax ID family

Jane Addams Community MHC2 organizations share this tax ID, including this one

Part of

Jane Addams Community MHC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Jane Addams Comm Mental Health Center

  dba FHN Family Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Galena, IL
  • NPI 1679615363
  NPD tax ID

Locations

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599177600000",
    "number": "1073127148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 813",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610320813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 HIGHLAND VIEW DR",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326942",
            "telephone_number": "815-599-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANE ADDAMS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JANE ADDAMS COMMUNITY MENTAL HEALTH CENTER",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-02",
        "status": "A",
        "authorized_official_last_name": "MAZZARISI",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "815-599-7935"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FHN Family Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Farouk Isawi, MD
• Hanny Isawi, MD
• Suzette Antoinette Isokpunwu
• Stephanie Iverson
• Jeffrey John James, OD
• Jane Addams Community Mental Health Center (FHN Family Counseling Center)
• Jane Addams Community Mental Health Center
• Jane Addams Community Mental Health Center (FHN Family Counseling Center)
• Michael R Jay, LCPC
• Christopher W Jelinek, MD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Freeport, IL
• Providers in Freeport, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; 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.