Jill M Underwood, LCAC, MBA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

87000056A Issued in IN

Practice address

1552 W Lincolnway
Valparaiso, IN 46385-0300

Phone

(219) 548-9400

Fax

(219) 548-9444

NPI assigned

Jul 30, 2010

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 Business Administration

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 and National Provider Directory roles.

• Fresh Start Counseling

  • Addiction (Substance Use Disorder) Counselor
  • Valparaiso, IN
  • NPI 1114253218
  NPD (past)

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

{
    "created_epoch": "1280448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280448000000",
    "number": "1245544345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1552 W LINCOLNWAY",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463850300",
            "telephone_number": "219-548-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1552 W LINCOLNWAY",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463850300",
            "telephone_number": "219-548-9400",
            "fax_number": "219-548-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "JILL",
        "middle_name": "M",
        "credential": "LCAC, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-30",
        "last_updated": "2010-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87000056A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Valparaiso, IN
• Providers in Valparaiso, IN by specialty
• Addiction (Substance Use Disorder) Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2010; 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.