Jessica Joan Callahan, L.C.P.C.

Individual provider Active NPI Professional Counselor · Manhattan, IL

NPI 1962778068 · NPPES record last updated Mar 22, 2012

Key facts

NPI
1962778068
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
180.007876 (IL)
Practice address
310 Kay St
Manhattan, IL 60442-9278
Phone
(815) 474-9647
NPI assigned
Mar 22, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
180.007876ILMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180.007876 IL Yes

Addresses

Primary practice location

310 Kay St
Manhattan, IL 60442-9278

Mailing address

310 Kay St
Manhattan, IL 60442-9278
Phone (815) 474-9647

Other providers in Manhattan, IL

All providers in Manhattan, IL · Professional Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.