Jacqueline Lissette Vaca, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.008127 Issued in IL

Practice address

1432 N Hamlin Ave
Chicago, IL 60651-2142

Phone

(773) 805-6738

NPI assigned

Jul 12, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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.

• Community Counseling Centers of Chicago

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1083634901
  NPD (past)

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1487942454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 N RAVENSWOOD AVE",
            "address_2": "SUITE 245",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402713",
            "telephone_number": "773-769-0205",
            "fax_number": "773-765-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 N HAMLIN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606512142",
            "telephone_number": "773-805-6738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACA",
        "first_name": "JACQUELINE",
        "middle_name": "LISSETTE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-12",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.006285",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.008127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1616824",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Winnie Uzebu
• Nina D Uziel-Miller, PH.D.
• Chukwuemeka C Uzoka, M.D
• V Greene MD PC
• V K Patel MD SC
• Anthony Joseph Vaccarello, MD
• Lisa Vaccarello, PTA
• Rick Douglas Vaccarello, D.D.S.
• Anthony Vaccaro, M.D.
• Margaret Elizabeth Vacchiano

• 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 Dec 10, 2014; 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.