Alexis Jackson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

178.016241 Issued in IL

Practice address

19 N Grant St Ste 2C
Hinsdale, IL 60521-3368

Phone

(630) 580-8080

NPI assigned

Sep 3, 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

Electronic endpoints 1

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.

• Elevate Counseling and Wellness LLC

  • Mental Health Counselor
  • Hinsdale, IL
  • NPI 1225684087
  NPD

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1699389056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 N GRANT ST STE 2C",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 N GRANT ST STE 2C",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213368",
            "telephone_number": "630-580-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ALEXIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.016241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.elevatecounseling.com/",
            "affiliation": "N",
            "address_1": "19 N Grant St Ste 2C",
            "city": "Hinsdale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605213368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Clementa Istrata-Iacob
• Valerie Y Ito, MD
• Iveta Boyanchek MD SC
• Ronda Jaber
• Kinsey Meredith Jackson-Ford, CNM
• Tyra Jackson, FNP-BC
• Renee H Jacobs, MD
• Mark C. Jacobson, M.D
• Neeraj Jain, M.D.
• Ayisha Jameel, MD

• Mental Health Counselor in Hinsdale, IL
• Providers in Hinsdale, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.