Individual provider Active NPI

Jessica Huerta, LCPC

  • Mental Health Counselor
  • Forest Park, IL
National Provider Identifier
1376183293
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.011472 Issued in IL
Practice address
8311 Roosevelt Rd
Forest Park, IL 60130-2529
Phone
(708) 771-7000
NPI assigned
Jan 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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 180.011472 IL Primary

Addresses

Primary practice location

8311 Roosevelt Rd
Forest Park, IL 60130-2529

Mailing address

8311 Roosevelt Rd
Forest Park, IL 60130-2529

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260324002905 IL Practitioner - Mental Health Counselor 8921582339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

367 S Gulph Rd
Uhs
King of Prussia, PA 19406-3191

8311 W Roosevelt Rd
Outpatient Department
Forest Park, IL 60130-2500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180.011472ILMDMental Health Counselor

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": "1578441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1376183293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8311 ROOSEVELT RD",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8311 ROOSEVELT RD",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302529",
            "telephone_number": "708-771-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUERTA",
        "first_name": "JESSICA",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-08",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.011472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Park, IL

Sources for this page

Verify at the official NPI Registry.