Active NPI
Janice G Cook, LCSW
- Counselor
- Mt Vernon, IL
National Provider Identifier
1689728552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 149006900
- Practice address
- 123 S 10TH St
Ste 510
Mt Vernon, IL 62864 - Phone
- (618) 242-8139
- Fax
- (618) 242-8141
- NPI assigned
- Jan 22, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 149006900 | IL | Primary |
Addresses
Primary practice location
123 S 10TH St
Ste 510
Mt Vernon, IL 62864
Mailing address
123 S 10TH St
Ste 510
Mt Vernon, IL 62864
Phone (618) 242-8139
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149006900 | IL | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mt. Vernon Counseling Center, Inc. | Counselor | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210809600000",
"number": "1689728552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 S 10TH ST",
"address_2": "STE 510",
"city": "MT VERNON",
"state": "IL",
"postal_code": "62864",
"telephone_number": "618-242-8139",
"fax_number": "618-242-8141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 S 10TH ST",
"address_2": "STE 510",
"city": "MT VERNON",
"state": "IL",
"postal_code": "62864",
"telephone_number": "618-242-8139",
"fax_number": "618-242-8141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "JANICE",
"middle_name": "G",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2008-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": "149006900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mt Vernon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.