NPIMap

Organization Active NPI

360 Youth Services

  • Professional Counselor
  • Naperville, IL
National Provider Identifier
1336690239
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180010400 Issued in IL
Legal business name
360 YOUTH SERVICES
Practice address
1548 Bond St Ste 114
Naperville, IL 60563-6509
Phone
(630) 717-9408
Fax
(630) 596-8496
NPI assigned
Oct 17, 2016
Last updated
Oct 17, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Jessica Kujawa
Title
Biller
Phone
(630) 541-7219

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180010400 IL Primary

Addresses

Primary practice location

1548 Bond St Ste 114
Naperville, IL 60563-6509

Mailing address

1548 Bond St Ste 114
Naperville, IL 60563-6509
Phone (630) 717-9408

National Provider Directory

National Provider Directory
Tax ID family
360 Youth Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476662400000",
    "number": "1336690239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1548 BOND ST STE 114",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605636509",
            "telephone_number": "630-717-9408",
            "fax_number": "630-596-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1548 BOND ST STE 114",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605636509",
            "telephone_number": "630-717-9408",
            "fax_number": "630-596-8496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 YOUTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A",
        "authorized_official_last_name": "KUJAWA",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "630-541-7219",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180010400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.