Jolene Kayla Stoller, ALMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

208000762 Issued in IL

Practice address

110 E Countryside Pkwy Ste C
Yorkville, IL 60560-1814

Phone

(630) 553-1600

Fax

(630) 553-7993

NPI assigned

Jan 15, 2020

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

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.

• Centennial Counseling Center, PC

  • Mental Health Counselor
  • St Charles, IL
  • NPI 1376544387

  Mental Health

  NPD

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1689214926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 E MAIN ST STE 201",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742287",
            "telephone_number": "630-377-6613",
            "fax_number": "630-377-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E COUNTRYSIDE PKWY STE C",
            "city": "YORKVILLE",
            "state": "IL",
            "postal_code": "605601814",
            "telephone_number": "630-553-1600",
            "fax_number": "630-553-7993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLLER",
        "first_name": "JOLENE",
        "middle_name": "KAYLA",
        "credential": "ALMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "208000762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Yorkville, IL
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.