Jeanne Coulson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

178011217 Issued in IL

Practice address

360 Memorial Dr Ste 160
Crystal Lake, IL 60014-6203

Phone

(847) 754-7398

NPI assigned

May 4, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Real Life Counseling, PLLC

  • Professional Counselor
  • Crystal Lake, IL
  • NPI 1558936773
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1972959377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 VINE ST",
            "city": "HAMPSHIRE",
            "state": "IL",
            "postal_code": "601405620",
            "telephone_number": "847-754-7394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 MEMORIAL DR STE 160",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146203",
            "telephone_number": "847-754-7398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULSON",
        "first_name": "JEANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-04",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178011217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Kathleen Cooper
• Angela Cord
• Evan R Corsolini, DPT
• Emily Anne Corson
• Otto Alejandro Corzo, LSW
• Counseling With Purpose LLC
• Jenna Coutant, APRN
• Rodney Covenah, D.D.S.
• Coventry Eyecare Associates, LTD.
• Jennifer Cox, LCPC

• Mental Health Counselor in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.