Jessica Walters, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178018072 Issued in IL

Practice address

3411 N Albany Ave Apt 2
Chicago, IL 60618-8659

Phone

(248) 534-7053

NPI assigned

Jul 12, 2022

Sex

Female

Sole proprietor

No

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

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

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Refuah Health CenterGroup PAC ID 5193103653, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Midwest Refuah Health Center

  • Clinic/Center
  • Chicago, IL
  • NPI 1518601004
  Medicare reassignment Care Compare group NPD
• Midwest Refuah Health Center

  • Radiology Clinic/Center
  • Chicago, IL
  • NPI 1962219691
  NPD
• Lifepath Therapy Associates, LLC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1629636394

  Professional

  NPD (past)

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678579200000",
    "number": "1427782770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 N ALBANY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606188659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 N ALBANY AVE APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606188659",
            "telephone_number": "248-534-7053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "JESSICA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2023-03-12",
        "certification_date": "2023-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178018072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel J. Walters, DPM
• David Walters, FNP-BC
• Elizabeth A Walters, PA-C
• Jason Walters, PT
• Jenna Walters, PT, DPT
• Kynyahta L Walters, APRN, FNP-C
• Lorna V Walters, D.P.M.
• Robert Walters, PHD
• Tija Walters
• Velma Jayne Walters, P.T.

• Professional Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2023; 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.

Verify at the official NPI Registry.