Active NPI
L. Jane Wilson, LMFT
- Marriage & Family Therapist
- Champaign, IL
National Provider Identifier
1326258864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 809 W Church St
Champaign, IL 61820-3320 - Phone
- (217) 373-1850
- Fax
- (217) 373-1856
- NPI assigned
- May 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IL | Primary |
Addresses
Primary practice location
809 W Church St
Champaign, IL 61820-3320
Mailing address
1398 East 2250 North Road
White Heath, IL 61884-0000
Phone (217) 687-4132
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 |
|---|---|---|---|
| 166.000189 | IL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326258864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1398 EAST 2250 NORTH ROAD",
"city": "WHITE HEATH",
"state": "IL",
"postal_code": "618840000",
"telephone_number": "217-687-4132",
"fax_number": "217-373-1856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "809 W CHURCH ST",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618203320",
"telephone_number": "217-373-1850",
"fax_number": "217-373-1856"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "L.",
"middle_name": "JANE",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.