NPIMap

Organization Active NPI

Human Support Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waterloo, IL
National Provider Identifier
1851314918
Registry record updated Nov 26, 2018
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
988 N Illinois Route 3
Waterloo, IL 62298-1000
Phone
(618) 939-4444
Fax
(618) 939-4181
NPI assigned
Jul 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2018

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

Authorized official

Name
Melissa JonesNPI 1669021002
Title
Business Manager
Phone
(618) 939-4444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

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

Addresses

Primary practice location

988 N Illinois Route 3
Waterloo, IL 62298-1000

Mailing address

988 N Illinois Route 3
PO Box 146
Waterloo, IL 62298-1000
Phone (618) 939-4444

Other identifiers 2

IdentifierTypeStateIssuer
10B862OtherMOBLUE CROSS BLUE SHIELD
067-15560OtherILBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080422000307 IL Part B Supplier - Clinic/Group Practice 8729166434 Receives reassigned benefits from 6 practitioners
Practice locations: Waterloo, IL

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

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543190400000",
    "number": "1851314918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988 N ILLINOIS ROUTE 3",
            "address_2": "PO BOX 146",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981000",
            "telephone_number": "618-939-4444",
            "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": {
        "organization_name": "HUMAN SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2018-11-26",
        "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": "IL",
            "license": "N/A",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "10B862",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "067-15560",
            "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 Nov 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.