Jacquelyn E Augustine Psy.D PC

Primary specialty

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

Legal business name

JACQUELYN E AUGUSTINE PSY.D PC

Practice address

1938 E Lincoln Hwy
New Lenox, IL 60451-3810

Phone

(708) 214-2448

NPI assigned

Jan 26, 2022

Organization subpart

No

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

Authorized official

Name

Jacquelyn E Augustine, PSYDNPI 1619286986

Title

President

Phone

(708) 214-2448

Specialties & licenses 2

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacquelyn Eileen Augustine, PSY.D.

  • Counselor
  • Naperville, IL
  • NPI 1619286986
  NPD Authorized official

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

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645488000000",
    "number": "1083366470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11784 GOLDEN GATE DR",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604482033",
            "telephone_number": "708-214-2448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1938 E LINCOLN HWY",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604513810",
            "telephone_number": "708-214-2448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11784 Golden Gate Dr",
            "address_purpose": "LOCATION",
            "city": "Mokena",
            "state": "IL",
            "postal_code": "604482033",
            "country_code": "US",
            "telephone_number": "708-214-2448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JACQUELYN E AUGUSTINE PSY.D PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A",
        "authorized_official_last_name": "AUGUSTINE",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-214-2448",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jackie@augustinewellness.org",
            "affiliation": "N",
            "address_1": "11784 Golden Gate Dr",
            "city": "Mokena",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604482033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Integrated Care Pharmacy
• Integrated Physical Medicine, LLC
• Julie M Jachimek, PT
• James W Jackson, M.S., BCBA
• Jaclyn Kamradt PHD, P.C.
• Constance Jaegle, R.N., M.S., NP
• Parag Jain, M.D
• Nathan R Jaisingh, NP
• James T Niemeyer DO SC
• Zayna Jan, DDS

• Mental Health Clinic/Center (Including Community Mental Health Center) in New Lenox, IL
• Providers in New Lenox, 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 Feb 22, 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.