Jacob Ryan Pritchard, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180009401 Issued in IL

Practice address

3400 W New Leaf LN
Peoria, IL 61615-3311

Phone

(309) 671-8000

NPI assigned

Feb 26, 2015

Last updated

Feb 15, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Compass Mental Health Solutions LLC

  • Adult Mental Health Clinic/Center
  • Peoria, IL
  • NPI 1376176651
  NPD Authorized official
• Linq Therapy, LLC

  dba Linq Therapy

  • Mental Health Counselor
  • Frisco, TX
  • NPI 1801461371
  NPD (past)

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

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581724800000",
    "number": "1609268747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2802 N WOODBINE TER",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616042126",
            "telephone_number": "309-642-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W NEW LEAF LN",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616153311",
            "telephone_number": "309-671-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRITCHARD",
        "first_name": "JACOB",
        "middle_name": "RYAN",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-26",
        "last_updated": "2020-02-15",
        "certification_date": "2020-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180009401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS",
            "identifier": "180009401",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Renee Priddy
• Jantzen Michelle Pride, MD
• James G. Priepot, M.D.
• Prime Care Services LLC
• Mandie Geneil Prior, DO
• Proctor Community Hospital (Proctor Hospital)
• Proctor Community Hospital (Proctor Hospital)
• Proctor Community Hospital
• Proctor Community Hospital (Proctor Hospital)
• Proctor Community Hospital (Proctor Home Care)

• Mental Health Counselor in Peoria, IL
• Providers in Peoria, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2020; 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.