Emily Jane Ballew, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.018389 Issued in IL

Practice address

309 W Clark St
Champaign, IL 61820-4637

Phone

(217) 398-9066

Fax

(217) 398-9077

NPI assigned

Sep 22, 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 names 1

• Emily Jane Keating Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1124741301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 W CLARK ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618204637",
            "telephone_number": "217-398-9066",
            "fax_number": "217-398-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 W CLARK ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618204637",
            "telephone_number": "217-398-9066",
            "fax_number": "217-398-9077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 Philo Rd",
            "address_purpose": "LOCATION",
            "city": "Urbana",
            "state": "IL",
            "postal_code": "618028007",
            "country_code": "US",
            "telephone_number": "217-552-1211",
            "fax_number": "217-398-9077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALLEW",
        "first_name": "EMILY",
        "middle_name": "JANE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-22",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.018389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "KEATING",
            "middle_name": "JANE",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Champaign, IL
• Professional Counselor in Illinois

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