Active NPI
Jeridith Ann Lord, LCPC
- Mental Health Counselor
- Woodstock, IL
National Provider Identifier
1932743663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 180.013771
- Practice address
- 226 W Judd St
Woodstock, IL 60098-3158 - Phone
- (815) 575-8860
- NPI assigned
- Nov 6, 2019
- Last updated
- Sep 9, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 180.013771 | IL | Primary |
Addresses
Primary practice location
226 W Judd St
Woodstock, IL 60098-3158
Mailing address
PSC 37, Box 3086
Apo, AE 09459
Phone (516) 308-6951
Other practice location 1
66 Lamble Close, Beck Row
Bury St. Edmunds, Suffolk Ip28 8db
GB
Phone (516) 308-6951
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
| License | State | Type | Specialty |
|---|---|---|---|
| 180.013771 | IL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662681600000",
"number": "1932743663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "PSC 37, BOX 3086",
"city": "APO",
"state": "AE",
"postal_code": "09459",
"telephone_number": "516-308-6951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "226 W JUDD ST",
"city": "WOODSTOCK",
"state": "IL",
"postal_code": "600983158",
"telephone_number": "815-575-8860"
}
],
"practiceLocations": [
{
"address_1": "66 Lamble Close, Beck Row",
"address_purpose": "LOCATION",
"city": "Bury St. Edmunds",
"state": "Suffolk",
"postal_code": "Ip28 8db",
"country_code": "GB",
"telephone_number": "516-308-6951",
"country_name": "Great Britain",
"address_type": "FGN"
}
],
"basic": {
"last_name": "LORD",
"first_name": "JERIDITH",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-06",
"last_updated": "2022-09-09",
"certification_date": "2022-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "180.013771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodstock, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.