Active NPI
Jessica Pippin, LPC
- Counselor
- Bloomington, IL
National Provider Identifier
1265818934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 18.012780
- Practice address
- 103 N Regency Dr
Bloomington, IL 61701-3570 - Phone
- (309) 661-8046
- Fax
- (309) 661-8093
- NPI assigned
- Aug 5, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178009900 | IL | |
| Counselor | 101Y00000X | 18.012780 | IL | Primary |
Addresses
Primary practice location
103 N Regency Dr
Bloomington, IL 61701-3570
Mailing address
103 N Regency Dr
Bloomington, IL 61701-3570
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18.012780 | IL | MD | Counselor |
| 178009900 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585958400000",
"number": "1265818934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 N REGENCY DR",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617013570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 N REGENCY DR",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617013570",
"telephone_number": "309-661-8046",
"fax_number": "309-661-8093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIPPIN",
"first_name": "JESSICA",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-05",
"last_updated": "2020-04-04",
"certification_date": "2020-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "178009900",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": "18.012780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.