Healthcare Provider Details

I. General information

NPI: 1407106701
Provider Name (Legal Business Name): JEM COUNSELING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2012
Last Update Date: 09/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

977 LAKEVIEW PKWY STE 180
VERNON HILLS IL
60061-1429
US

IV. Provider business mailing address

977 LAKEVIEW PKWY STE 180
VERNON HILLS IL
60061-1429
US

V. Phone/Fax

Practice location:
  • Phone: 847-875-9804
  • Fax: 847-549-7005
Mailing address:
  • Phone: 847-875-9804
  • Fax: 847-549-7005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180006260
License Number StateIL

VIII. Authorized Official

Name: MRS. JENNIFER L STENNETT
Title or Position: PRESIDENT/PSYCHOTHERAPIST
Credential: LCPC
Phone: 847-875-9804