NPIMap

Organization Active NPI

Human Support Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waterloo, IL
National Provider Identifier
1801447982
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
HUMAN SUPPORT SERVICES
Practice address
228 Bradford LN Ste 2
Waterloo, IL 62298-3270
Phone
(618) 939-4444
NPI assigned
Sep 20, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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

Authorized official

Name
Melissa Jones
Title
Business Manager
Phone
(618) 939-4444

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

228 Bradford LN Ste 2
Waterloo, IL 62298-3270

Mailing address

988 N Illinois Route 3
Waterloo, IL 62298-1059
Phone (618) 939-4444

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Human Support Services18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1568937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568937600000",
    "number": "1801447982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988 N ILLINOIS ROUTE 3",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981059",
            "telephone_number": "618-939-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 BRADFORD LN STE 2",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622983270",
            "telephone_number": "618-939-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMAN SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-20",
        "last_updated": "2019-09-20",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "618-939-4444"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "IL"
        }
    ],
    "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 Sep 20, 2019; 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.