Jessica Johana Juarez, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

178.016898 Issued in IL

Practice address

2659 W Division St
Chicago, IL 60622-2851

Phone

(312) 219-5780

NPI assigned

Jan 4, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Fly Radical Therapy, LLC

  • Professional Counselor
  • Chicago, IL
  • NPI 1720745912
  NPD (past)

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1407517261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2659 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222851",
            "telephone_number": "773-577-7285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2659 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222851",
            "telephone_number": "312-219-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUAREZ",
        "first_name": "JESSICA",
        "middle_name": "JOHANA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.016898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Paulina Juarez Escutia, OTR/L
• Eleanor Elizabeth Juarez, PSY.D.
• Elizabeth Juarez
• Isabella Juarez
• Jean Juarez, LMFT
• Monica Juarez
• Rodrigo Juarez Jr., D.C.
• Froilan A Juat, MD
• Mary Juba, RN
• Christina Juber, DPM

• Mental Health Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.