Jayshree Panchal, MA, LCPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.010474 Issued in IL

Practice address

7210 N Villa Lake Dr Ste C
Peoria, IL 61614-8290

Phone

(309) 713-1485

Fax

(309) 419-4328

NPI assigned

Feb 24, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• Summit Family Therapy PLLC

  • Professional Counselor
  • Peoria, IL
  • NPI 1548704372
  NPD

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

{
    "created_epoch": "1393200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1639594971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7210 N VILLA LAKE DR STE C",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148290",
            "telephone_number": "309-713-1485",
            "fax_number": "309-419-4328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7210 N VILLA LAKE DR STE C",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148290",
            "telephone_number": "309-713-1485",
            "fax_number": "309-419-4328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3248 Vandever Ave",
            "address_purpose": "LOCATION",
            "city": "Pekin",
            "state": "IL",
            "postal_code": "615546257",
            "country_code": "US",
            "telephone_number": "309-347-5579",
            "fax_number": "309-347-4264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANCHAL",
        "first_name": "JAYSHREE",
        "credential": "MA, LCPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-24",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.010474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Palmer
• Aadi Rajeevkumar Palvia, MBBS
• Erica Pamson
• Raymond Pancho Panaligan
• Amar Pancar
• Kristine Michelle Papis, APN
• Aryn Alissa Pardieck, MA, LCPC
• Brenna Michelle Pardieck
• Nishi Parikh, MD
• Chang Hwan Park, MD

• Professional Counselor in Peoria, IL
• Providers in Peoria, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.