Alyssa Jurkus
Individual provider Active NPI Mental Health Counselor · Wheaton, IL
NPI 1619459658 · NPPES record last updated Sep 6, 2018
Key facts
- NPI
- 1619459658
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 111 N County Farm Rd
Wheaton, IL 60187-3977 - Phone
- (630) 682-7400
- NPI assigned
- Sep 6, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
111 N County Farm Rd
Wheaton, IL 60187-3977
Mailing address
111 N County Farm Rd
Wheaton, IL 60187-3977
NPI Registry JSON
{
"created_epoch": "1536192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536192000000",
"number": "1619459658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 N COUNTY FARM RD",
"city": "WHEATON",
"state": "IL",
"postal_code": "601873977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 N COUNTY FARM RD",
"city": "WHEATON",
"state": "IL",
"postal_code": "601873977",
"telephone_number": "630-682-7400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JURKUS",
"first_name": "ALYSSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-06",
"last_updated": "2018-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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All providers in Wheaton, IL · Mental Health Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.