Active NPI
MJ Counseling LTD
- Adult Mental Health Clinic/Center
- St Charles, IL
National Provider Identifier
1982482725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Mental Health Clinic/Center
- Legal business name
- MJ COUNSELING LTD
- Doing business as
- Marissa Millonzi
- Practice address
- 40W927 Il Route 64
St Charles, IL 60175-5314 - Phone
- (310) 993-5230
- NPI assigned
- Sep 21, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Marissa Jepsen, LCSW
- Title
- President
- Phone
- (310) 993-5230
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Mental Health Clinic/Center | 261QM0850X | Primary |
Addresses
Primary practice location
40W927 Il Route 64
St Charles, IL 60175-5314
Mailing address
40W927 Il Route 64
St Charles, IL 60175-5314
Phone (310) 993-5230
Other names 1
- Marissa Millonzi
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695254400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1695254400000",
"number": "1982482725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40W927 IL ROUTE 64",
"city": "ST CHARLES",
"state": "IL",
"postal_code": "601755314",
"telephone_number": "310-993-5230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40W927 IL ROUTE 64",
"city": "ST CHARLES",
"state": "IL",
"postal_code": "601755314",
"telephone_number": "310-993-5230"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MJ COUNSELING LTD",
"organizational_subpart": "NO",
"enumeration_date": "2023-09-21",
"last_updated": "2023-09-21",
"certification_date": "2023-09-21",
"status": "A",
"authorized_official_last_name": "JEPSEN",
"authorized_official_first_name": "MARISSA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "310-993-5230",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "261QM0850X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Marissa Millonzi",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in St Charles, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.