Jacqulyn Braxton
Individual provider Active NPI Professional Counselor · Northfield, IL
NPI 1285496604 · NPPES record last updated Aug 6, 2026
Key facts
- NPI
- 1285496604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 180018614 (IL)
- Practice address
- 405 Central Ave
Northfield, IL 60093-3006 - Phone
- (847) 441-7968
- NPI assigned
- Jan 30, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Josselyn Center NFP
Practice addresses (Care Compare)
1135 Skokie Blvd
Northbrook, IL 60062-4118
Phone (847) 441-5600
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251204002529 | IL | Practitioner - Mental Health Counselor | 6204329584 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Josselyn Center NFP | Current |
Accepting new patients | |
| The Josselyn Center NFP | Current |
Accepting new patients |
Locations
1135 Skokie Blvd
Northbrook, IL 60062
Phone (773) 430-3351
405 Central Ave
Northfield, IL 60093
Phone (847) 441-5603
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180018614 | IL | Yes |
Addresses
Primary practice location
405 Central Ave
Northfield, IL 60093-3006
Mailing address
405 Central Ave
Northfield, IL 60093-3006
Phone (847) 441-7968
NPI Registry JSON
{
"created_epoch": "1706572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785974400000",
"number": "1285496604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 CENTRAL AVE",
"city": "NORTHFIELD",
"state": "IL",
"postal_code": "600933006",
"telephone_number": "847-441-7968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 CENTRAL AVE",
"city": "NORTHFIELD",
"state": "IL",
"postal_code": "600933006",
"telephone_number": "847-441-7968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAXTON",
"first_name": "JACQULYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-30",
"last_updated": "2026-08-06",
"certification_date": "2026-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180018614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northfield, IL
- Brittany Borucki
- Ellie Boushie
- Mary Bowers
- Erin Shea Brady
- Kristen Braman
- Breakthrough Psychotherapy, Llo
- Joshua Breger
- Marianne B Brennan
- Amy Briggs
- Chloe Brodner
All providers in Northfield, IL · Professional Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.