Jahaan Abdullah, LPC
Individual provider Active NPI Professional Counselor · Sycamore, IL
NPI 1639628654 · NPPES record last updated Oct 3, 2016
Key facts
- NPI
- 1639628654
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 178.010738 (IL)
- Practice address
- 2535 Bethany Rd
Suite 210
Sycamore, IL 60178-3126 - Phone
- (815) 264-2154
- Fax
- (815) 264-2315
- NPI assigned
- Oct 3, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.010738 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lighthouse Professional Counseling Center, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178.010738 | IL | Yes |
Addresses
Primary practice location
2535 Bethany Rd
Suite 210
Sycamore, IL 60178-3126
Mailing address
2535 Bethany Rd
Suite 210
Sycamore, IL 60178-3126
Phone (815) 264-2154
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 178.010738 | Other | IL | ILLINOIS COUNSELING LICENSE |
Other providers in Sycamore, IL
- A Bridge to Healing PC
- Abraham N. Lotan, MD
- Advanced Family Eyecare Ctr. Inc
- Advanced Foot and Ankle Surgeons Inc
- Advanced Optometry
- Maria Caridad Aguilera Astudillo
All providers in Sycamore, IL · Professional 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 Oct 3, 2016. 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.