Jackson Mancuso, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.020916 Issued in IL

Practice address

1 Westminster PL Ste 101
Lake Forest, IL 60045-5511

Phone

(847) 919-9096

NPI assigned

Oct 31, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Inspire Counseling Center, LLC

  • Professional Counselor
  • Northbrook, IL
  • NPI 1295289726
  NPD (past)

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

{
    "created_epoch": "1730332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1780406512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E SHERIDAN PL",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600442637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WESTMINSTER PL STE 101",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600455511",
            "telephone_number": "847-919-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCUSO",
        "first_name": "JACKSON",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.020916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary S Maish, MD
• Aaron Charles Malina, PH.D.
• Julia Margret Malloy, NP-C
• Michaela Malone
• Sara N. Mammoser, PT/DPT
• Shayna Mancuso, D.O.
• Priyal P Mangrola, DMD
• Corinne Manny
• Shana Leah Margolis, M.D.
• Deborah M Margulis, MD

• Professional Counselor in Lake Forest, IL
• Providers in Lake Forest, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.