Individual provider Active NPI

Lorice Jean

  • Professional Counselor
  • Racine, WI
National Provider Identifier
1992147870
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6125-125 Issued in WI
Practice address
1717 Taylor Ave
Racine, WI 53403-2405
Phone
(262) 638-6744
NPI assigned
Jul 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6125-125 WI Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 16058-132 WI

Addresses

Primary practice location

1717 Taylor Ave
Racine, WI 53403-2405

Mailing address

1717 Taylor Ave
Racine, WI 53403-2405
Phone (262) 638-6744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20250709000142 GA Practitioner - Mental Health Counselor 2466966866 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16058-132WIMDAddiction (Substance Use Disorder) Counselor
6125-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Journey House International Center LLC Addiction (Substance Use Disorder) CurrentSince Apr 21, 2025 Accepting new patients

Locations

2488 Lakewood Ave SW
Atlanta, GA 30315
Phone (404) 282-6028

Organizations & group practices 1

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": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1992147870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 TAYLOR AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534032405",
            "telephone_number": "262-638-6744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 TAYLOR AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534032405",
            "telephone_number": "262-638-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN",
        "first_name": "LORICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-22",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6125-125",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16058-132",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

Verify at the official NPI Registry.