Individual provider Active NPI

Angela Jochem, BS, LPN

  • Mental Health Counselor
  • Vienna, IL
National Provider Identifier
1689253999
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
101 Oliver St
Vienna, IL 62995-1660
Phone
(618) 658-2611
Fax
(618) 658-2501
NPI assigned
Apr 5, 2021
Last updated
Apr 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Licensed Practical Nurse 164W00000X 043129978 IL

Addresses

Primary practice location

101 Oliver St
Vienna, IL 62995-1660

Mailing address

101 Oliver St
Vienna, IL 62995-1660
Phone (618) 658-2611

Other practice location 1

147 N Main St
Elizabethtown, IL 62931-4463
Phone (618) 287-7010

Other practice location 2

1401 Washington Ave
Cairo, IL 62914-1810
Phone (618) 734-2665

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
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
043129978ILMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Arrowleaf CurrentSince Apr 11, 2021 Accepting new patients
Arrowleaf Mental Health PastSince Apr 11, 2021 Accepting new patients

Locations

1401 Washington Ave
Cairo, IL 62914
Phone (618) 734-2665

147 N Main St
Elizabethtown, IL 62931
Phone (618) 287-7010

101 Oliver St
Vienna, IL 62995
Phone (618) 658-2611

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1689253999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 OLIVER ST",
            "city": "VIENNA",
            "state": "IL",
            "postal_code": "629951660",
            "telephone_number": "618-658-2611",
            "fax_number": "618-658-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 OLIVER ST",
            "city": "VIENNA",
            "state": "IL",
            "postal_code": "629951660",
            "telephone_number": "618-658-2611",
            "fax_number": "618-658-2501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "147 N Main St",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "IL",
            "postal_code": "629314463",
            "country_code": "US",
            "telephone_number": "618-287-7010",
            "fax_number": "618-287-7016",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1401 Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Cairo",
            "state": "IL",
            "postal_code": "629141810",
            "country_code": "US",
            "telephone_number": "618-734-2665",
            "fax_number": "618-734-1999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOCHEM",
        "first_name": "ANGELA",
        "credential": "BS, LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043129978",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; 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.