Active NPI
Jennifer Mueller, LCPC
- Professional Counselor
- Evanston, IL
National Provider Identifier
1689707242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180-002742
- Practice address
- 838 Elmwood Ave
Unit #1
Evanston, IL 60202 - Phone
- (847) 570-0150
- NPI assigned
- Mar 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180-002742 | IL | Primary |
Addresses
Primary practice location
838 Elmwood Ave
Unit #1
Evanston, IL 60202
Mailing address
838 Elmwood Ave
Unit #1
Evanston, IL 60202
Phone (847) 570-0150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1626957 | Other | IL | BCBS OF ILLINOIS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 21, 2024 through Feb 21, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180-002742 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602720000000",
"number": "1689707242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "838 ELMWOOD AVE",
"address_2": "UNIT #1",
"city": "EVANSTON",
"state": "IL",
"postal_code": "60202",
"telephone_number": "847-570-0150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "838 ELMWOOD AVE",
"address_2": "UNIT #1",
"city": "EVANSTON",
"state": "IL",
"postal_code": "60202",
"telephone_number": "847-570-0150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUELLER",
"first_name": "JENNIFER",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-13",
"last_updated": "2020-10-15",
"certification_date": "2020-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180-002742",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF ILLINOIS",
"identifier": "1626957",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.