Individual provider Active NPI

Jamin M Wright, LCPC

  • Mental Health Counselor
  • Orland Park, IL
National Provider Identifier
1457806606
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180010460 Issued in IL
Practice address
62 Orland Square Dr
101
Orland Park, IL 60462-6546
Phone
(708) 349-5433
NPI assigned
Aug 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

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 180010460 IL Primary

Addresses

Primary practice location

62 Orland Square Dr
101
Orland Park, IL 60462-6546

Mailing address

62 Orland Square Dr
101
Orland Park, IL 60462-6546

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
I20260213002001 IL Practitioner - Mental Health Counselor 6406336072 Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10725 S Western Ave
Chicago, IL 60643-3217
Phone (217) 848-2257

16144 Bormet Dr
Tinley Park, IL 60477-6362

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180010460ILMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1457806606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 ORLAND SQUARE DR",
            "address_2": "101",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604626546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 ORLAND SQUARE DR",
            "address_2": "101",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604626546",
            "telephone_number": "708-349-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "JAMIN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-17",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180010460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.