Jahaan Abdullah, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.010738 Issued in 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

Last updated

Oct 3, 2016By the provider in NPPES

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

State licenses

Practice roles

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.

• Lighthouse Professional Counseling Center, LLC

  • Community/Behavioral Health Agency
  • Sycamore, IL
  • NPI 1659720332
  NPD (past)

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1639628654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 BETHANY RD",
            "address_2": "SUITE 210",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783126",
            "telephone_number": "815-264-2154",
            "fax_number": "815-264-2315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 BETHANY RD",
            "address_2": "SUITE 210",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783126",
            "telephone_number": "815-264-2154",
            "fax_number": "815-264-2315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDULLAH",
        "first_name": "JAHAAN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.010738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.

Verify at the official NPI Registry.