Jenna Pavlik, MA

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

210 N Wolf Rd
Wheeling, IL 60090-2922

Phone

(847) 353-1500

NPI assigned

Nov 4, 2022

Last updated

Nov 4, 2022By 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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

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.

• Omni Youth Services, Inc.

  dba EDGE Counseling Solutions

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Buffalo Grove, IL
  • NPI 1124401179
  Medicare reassignment NPD
• Omni Youth Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wheeling, IL
  • NPI 1134369663
  NPD (past)
• Omni Youth Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Wheeling, IL
  • NPI 1720525678
  NPD (past)

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

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1265149660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N WOLF RD",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600902922",
            "telephone_number": "847-353-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N WOLF RD",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600902922",
            "telephone_number": "847-353-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLIK",
        "first_name": "JENNA",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Patt
• Julie Ann Patton, AU.D
• Paul Potach D.P.M. P.C. (Dundee Foot & Ankle Center)
• Paul Potach D.P.M.,P.C.
• Paul Potach, DPM, PC (Dundee Foot and Ankle Center)
• Vincent J Pellettieri, DDS
• Percipience Home Care LLC
• Percipience Home Health LLC
• Jaqueline Pereda, MSW
• Noelia Perez

• Counselor in Wheeling, IL
• Providers in Wheeling, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.