Jason Collins, SSP
Individual provider Active NPI School Psychologist · Eureka, IL
NPI 1457029027 · NPPES record last updated Aug 31, 2021
Key facts
- NPI
- 1457029027
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- Practice address
- 719 S Forest Park Dr
Eureka, IL 61530-1513 - Phone
- (309) 258-7607
- NPI assigned
- Aug 31, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | Yes |
Addresses
Primary practice location
719 S Forest Park Dr
Eureka, IL 61530-1513
Mailing address
719 S Forest Park Dr
Eureka, IL 61530-1513
Other providers in Eureka, IL
- Bromenn Physicians Management Corporation
- Joseph Gerard Burns
- Carle Eureka Hospital
- Carle Eureka Hospital
- Carle Eureka Hospital
- County of Woodford Eureka Congerville Goodfld Dist 140
- David Howard Crenshaw
- Michael T Detweiler
- Victoria L Diekhoff
- Elite Chiropractic Services, LLC
All providers in Eureka, IL · School Psychologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.