Kimberly Joy De Jong, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

6006 159TH St BLDG C
The Genesis Therapy Center
Oak Forest, IL 60452-2904

Phone

(708) 535-7320

NPI assigned

Aug 13, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Erawan Counseling, LLC

  • Professional Counselor
  • Griffith, IN
  • NPI 1679177919
  Authorized official Same address or phone
• Genesis Therapy Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oak Forest, IL
  • NPI 1447264890
  NPD (past)

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093727281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4232 143RD ST",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "604452600",
            "telephone_number": "708-710-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6006 159TH ST BLDG C",
            "address_2": "THE GENESIS THERAPY CENTER",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604522904",
            "telephone_number": "708-535-7320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JONG",
        "first_name": "KIMBERLY",
        "middle_name": "JOY",
        "name_prefix": "Mrs.",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Curran, M.S.
• Kelsey M Dagenais, LCPC
• Lauren Elizabeth Danzie, RN
• Nivedita J Dave, MD
• David Chang Lee MD LTD
• Sheryl M Deboer
• Brittany Ann Delorenzo, BCBA
• Patricia Lynn Demarais, MD
• Rebecca Deno
• Dental Smiles of Oak Forest PC

• Professional Counselor in Oak Forest, IL
• Providers in Oak Forest, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.