MEDICARE: 101 WAYS NFP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0855X	Adolescent and Children Mental Health Clinic/Center
2	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1336089192
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	101 WAYS NFP

Provider Business Mailing Address
First Line	:	1313 CAMP JACKSON RD
Second Line	:
City	:	CAHOKIA HEIGHTS
State	:	IL
Zip	:	62206-2202
Country	:	US
Telephone Number	:	618-515-5004
Fax Number	:	618-515-5144

Provider Business Practice Location Address
First Line	:	1313 CAMP JACKSON RD
Second Line	:
City	:	CAHOKIA HEIGHTS
State	:	IL
Zip	:	62206-2202
Country	:	US
Telephone Number	:	618-515-5004
Fax Number	:	618-515-5144

Authorized Official
Title or Position	:	CEO
Name	:	JENNIFER ANDREWS
Credential	:	CHW
Telephone Number	:	618-799-7314

Provider Enumeration Date	:	03/31/2026
Last Update Date	:	05/04/2026

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