Individual provider Active NPI

Jenna Ann Riem

  • Mental Health Counselor
  • Naperville, IL
National Provider Identifier
1912510967
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178.016084 Issued in IL
Practice address
29 S Webster St Ste 390B
Naperville, IL 60540-5356
Phone
(630) 340-8747
NPI assigned
Aug 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178.016084 IL Primary

Addresses

Primary practice location

29 S Webster St Ste 390B
Naperville, IL 60540-5356

Mailing address

1505 Georgia CT Apt 301
Naperville, IL 60540-5061
Phone (815) 383-8401

Other practice location 1

40 N Broadway St
Coal City, IL 60416-1688
Phone (630) 352-7268

Other identifiers 1

IdentifierTypeStateIssuer
178.016084OtherILLICENSED PROFESSIONAL COUNSELOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
178.016084ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
515 Fitness Inc. CurrentSince Aug 1, 2020 Accepting new patients
Eunoia Counseling PastSince Oct 17, 2021 Accepting new patients

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": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1912510967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 GEORGIA CT APT 301",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605405061",
            "telephone_number": "815-383-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 S WEBSTER ST STE 390B",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605405356",
            "telephone_number": "630-340-8747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 N Broadway St",
            "address_purpose": "LOCATION",
            "city": "Coal City",
            "state": "IL",
            "postal_code": "604161688",
            "country_code": "US",
            "telephone_number": "630-352-7268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIEM",
        "first_name": "JENNA",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-28",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.016084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL COUNSELOR",
            "identifier": "178.016084",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; 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.