Active NPI
Jessica Huerta, LCPC
- Mental Health Counselor
- Forest Park, IL
National Provider Identifier
1376183293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 180.011472
- 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
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 |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 180.011472 | IL | MD | Mental 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.