Janice Elaine Willis, MS, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.005363 Issued in IL

Practice address

111 19TH Ave
Moline, IL 61265-3754

Phone

(309) 757-0300

Fax

(309) 757-0400

NPI assigned

Dec 14, 2007

Last updated

Dec 14, 2007By the provider in NPPES

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

Other names 1

• Janice Elaine Berry Former name

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, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Advanced Cardiovascular Consultants,SC

  • Specialist
  • Moline, IL
  • NPI 1588718910
  NPD
• Active Health & Wellness Center Inc

  • Chiropractor
  • Moline, IL
  • NPI 1740387927
  NPD (past)
• River Bend Christian Counseling Inc

  dba River Bend Christian Counseling

  • Substance Abuse Rehabilitation Facility
  • Moline, IL
  • NPI 1639170285
  NPD (past)

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197590400000",
    "number": "1568645414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 19TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612653754",
            "telephone_number": "309-757-0300",
            "fax_number": "309-757-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 19TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612653754",
            "telephone_number": "309-757-0300",
            "fax_number": "309-757-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "JANICE",
        "middle_name": "ELAINE",
        "credential": "MS, LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-14",
        "last_updated": "2007-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.005363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANICE",
            "last_name": "BERRY",
            "middle_name": "ELAINE",
            "credential": "MS, LCPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tiffany Ann Willard, D.C.
• Brittany Nicole Williams
• John Alan Williams, RPH
• John R Williams, D.D.S.
• Emily Willie, PHARMD
• Erica Willits, LCPC
• Jane Elizabeth Winston
• Logan Wissing
• Kirk Witherspoon, PHD
• Evan L Witt, PA-C

• Professional Counselor in Moline, IL
• Providers in Moline, 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 14, 2007; 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.