Individual provider Active NPI

Jennifer Tourville, MHP

  • Mental Health Counselor
  • Waterloo, IL
National Provider Identifier
1891344248
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178018621 Issued in IL
Practice address
988 N Illinois Route 3
Waterloo, IL 62298-1059
Phone
(618) 939-4444
NPI assigned
Sep 9, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Mental Health Counselor 101YM0800X 178018621 IL Primary

Addresses

Primary practice location

988 N Illinois Route 3
Waterloo, IL 62298-1059

Mailing address

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

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20240201003757 IL Practitioner - Mental Health Counselor 4082067392 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christian Social Services of IllinoisGroup PAC ID 3870068125, 3 clinicians
Human Support ServicesGroup PAC ID 8729166434, 3 clinicians

Practice addresses (Care Compare)

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

988 N Illinois Route 3
PO Box 146
Waterloo, IL 62298-0146
Phone (618) 939-4444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Human Support Services Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

988 N Illinois Route 3
Waterloo, IL 62298
Phone 61893944441242

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1891344248",
    "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": "988 N ILLINOIS ROUTE 3",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981059",
            "telephone_number": "618-939-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOURVILLE",
        "first_name": "JENNIFER",
        "credential": "MHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-09",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178018621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IL

Sources for this page

Verify at the official NPI Registry.