Individual provider Active NPI

Jerome Tyshon Hawkins

  • Mental Health Counselor
  • Yorkville, IL
National Provider Identifier
1194699934
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
708 N Bridge St
Yorkville, IL 60560-1105
Phone
(630) 966-4450
NPI assigned
Oct 3, 2025
Last updated
Oct 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IL Primary

Addresses

Primary practice location

708 N Bridge St
Yorkville, IL 60560-1105

Mailing address

1630 Plum St Apt 211
Aurora, IL 60506-3447
Phone (630) 486-5813

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Association for Individual Development CurrentSince Oct 5, 2025 Accepting new patients

Locations

708 N Bridge St
Yorkville, IL 60560
Phone (630) 966-4450

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1759449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1194699934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 PLUM ST APT 211",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605063447",
            "telephone_number": "630-486-5813",
            "fax_number": "630-486-5813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 N BRIDGE ST",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605601105",
            "telephone_number": "630-966-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "JEROME",
        "middle_name": "TYSHON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-03",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorkville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; 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.