Individual provider Active NPI

Jadyn Gebelein, LPC

  • Mental Health Counselor
  • Lake Bluff, IL
National Provider Identifier
1336957661
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178.019659 Issued in IL
Practice address
30055 N Waukegan Rd Apt 110
Lake Bluff, IL 60044-5418
Phone
(715) 203-3050
NPI assigned
Dec 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178.019659 IL Primary

Addresses

Primary practice location

30055 N Waukegan Rd Apt 110
Lake Bluff, IL 60044-5418

Mailing address

30055 N Waukegan Rd Apt 110
Lake Bluff, IL 60044-5418

Other practice location 1

1834 Walden Office Sq Ste 450
Schaumburg, IL 60173-4292
Phone (847) 359-5192

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

LicenseStateTypeSpecialty
178.019659ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Families and Adolescents in Recovery P.C. F.a.I.R. Counseling PastSince Aug 4, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1734566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1336957661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30055 N WAUKEGAN RD APT 110",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600445418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30055 N WAUKEGAN RD APT 110",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600445418",
            "telephone_number": "715-203-3050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1834 Walden Office Sq Ste 450",
            "address_purpose": "LOCATION",
            "city": "Schaumburg",
            "state": "IL",
            "postal_code": "601734292",
            "country_code": "US",
            "telephone_number": "847-359-5192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEBELEIN",
        "first_name": "JADYN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-19",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.019659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Bluff, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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.