Active NPI
Jennifer Nicole Shemonic, BA, LPC
- Professional Counselor
- Waterloo, IL
National Provider Identifier
1689787699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 988 N Illinois Route 3
Waterloo, IL 62298-1000 - Phone
- (618) 939-4444
- Fax
- (618) 939-4181
- NPI assigned
- Aug 16, 2006
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | IL | Primary |
Addresses
Primary practice location
988 N Illinois Route 3
Waterloo, IL 62298-1000
Mailing address
410 E 1St St
Ellis Grove, IL 62241-1462
Phone (618) 615-2113
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178-003834 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689787699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 E 1ST ST",
"city": "ELLIS GROVE",
"state": "IL",
"postal_code": "622411462",
"telephone_number": "618-615-2113",
"fax_number": "618-939-4181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "988 N ILLINOIS ROUTE 3",
"city": "WATERLOO",
"state": "IL",
"postal_code": "622981000",
"telephone_number": "618-939-4444",
"fax_number": "618-939-4181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEMONIC",
"first_name": "JENNIFER",
"middle_name": "NICOLE",
"credential": "BA, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterloo, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.