Jacquelyn Eileen Augustine, PSY.D.

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1415 Bond St Ste 127
Naperville, IL 60563-2769

Phone

(630) 355-9002

NPI assigned

Oct 4, 2010

Last updated

Jan 17, 2022By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 5, 2016 through Feb 5, 2028

Medicare enrollment (NPD)

Not enrolled

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.

• Jacquelyn E Augustine Psy.D PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New Lenox, IL
  • NPI 1083366470
  NPD Authorized official
• Dr Susan B Myket PC

  dba Susan Myket, PH.D. & Associates

  • Clinical Psychologist
  • Naperville, IL
  • NPI 1457570251
  NPD

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1619286986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 BOND ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632388",
            "telephone_number": "630-355-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 BOND ST STE 127",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632769",
            "telephone_number": "630-355-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUGUSTINE",
        "first_name": "JACQUELYN",
        "middle_name": "EILEEN",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-04",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008317",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Atlas Home Health Care, Inc.
• Atomicmedx PLLC
• Cindy Y. Atwi, PA-C
• Kathryn Marie Atzhorn, AU.D.
• Darby Marie Auckland, PA
• Lindsay Brooke Augustine, SLP
• Maggie W Augustyn, DDS
• Paris Jasmine Austell, MD
• Angela Austin
• Jennie N Austin, AU.D.

• Counselor in Naperville, IL
• Providers in Naperville, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.