Active NPI
Jill Marie Tam, MA, LPC
- Professional Counselor
- Springfield, MO
National Provider Identifier
1194356899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2019047996
- Practice address
- 2885 W Battlefield St
Springfield, MO 65807-3952 - Phone
- (417) 761-5214
- NPI assigned
- Jan 31, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2019047996 | MO | Primary |
Addresses
Primary practice location
2885 W Battlefield St
Springfield, MO 65807-3952
Mailing address
2885 W Battlefield St
Springfield, MO 65807-3952
Phone (417) 761-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019047996 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724025600000",
"number": "1194356899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2885 W BATTLEFIELD ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658073952",
"telephone_number": "417-761-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2885 W BATTLEFIELD ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658073952",
"telephone_number": "417-761-5214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAM",
"first_name": "JILL",
"middle_name": "MARIE",
"credential": "MA, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-31",
"last_updated": "2024-08-19",
"certification_date": "2024-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2019047996",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.