Active NPI
Jeremy Hooker, MSED, LCPC
- Professional Counselor
- Nachusa, IL
National Provider Identifier
1639538853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180.005647
- Practice address
- 1261 Il-38
Nachusa, IL 61057 - Phone
- (815) 284-7796
- NPI assigned
- Feb 16, 2016
- Last updated
- Feb 16, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180.005647 | IL | Primary |
Addresses
Primary practice location
1261 Il-38
Nachusa, IL 61057
Mailing address
PO Box 100
Nachusa, IL 61057-0100
Phone (815) 284-7796
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180.005647 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lutheran Social Services of Illinois | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba LSSI Nachusa
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Nachusa, IL
- NPI 1326216151
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455580800000",
"number": "1639538853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 100",
"city": "NACHUSA",
"state": "IL",
"postal_code": "610570100",
"telephone_number": "815-284-7796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1261 IL-38",
"city": "NACHUSA",
"state": "IL",
"postal_code": "61057",
"telephone_number": "815-284-7796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOOKER",
"first_name": "JEREMY",
"credential": "MSED, LCPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-02-16",
"last_updated": "2016-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180.005647",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nachusa, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.