Jodi Willems, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PC-0000954 Issued in DE

Practice address

153 E Chestnut Hill Rd Ste 209
Newark, DE 19713-4047

Phone

(302) 509-5888

NPI assigned

Nov 18, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Healing Source LLC

  • Mental Health Counselor
  • Newark, DE
  • NPI 1194364141
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1479427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1841733136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 STAMFORD DR APT 111",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197112789",
            "telephone_number": "302-981-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 E CHESTNUT HILL RD STE 209",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197134047",
            "telephone_number": "302-509-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLEMS",
        "first_name": "JODI",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-18",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC9141",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "DE",
            "license": "PC-0000954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Anthony Wilderman, PT DPT MS
• Rebecca Buonanno Wildman, PA-C
• Sarah Wile
• Kristin Wilhide, RN, BSN, CPN
• Ryan Cambridge Will
• JD Willetts II, PH.D.
• Judith Kay Willetts, PH.D.
• William B. Funk, M.D., PA
• William M Pollock, M.D., PA
• William R. Atkins Jr., M.D.

• Mental Health Counselor in Newark, DE
• Providers in Newark, DE by specialty
• Mental Health Counselor in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.