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NPI Code Detail

MEDICARE: JENNIFER BALLETO LCPC

MEDICARE: JENNIFER BALLETO LCPC
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
1101YP2500XProfessional Counselor180.013312IL

General Provider Information

NPI Number : 1558783100
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER BALLETO LCPC
Provider Business Mailing Address
First Line : 2028 N SEMINARY AVE
Second Line :
City : WOODSTOCK
State : IL
Zip : 60098-2626
Country : US
Telephone Number : 815-338-3590
Fax Number :
Provider Business Practice Location Address
First Line : 2028 N SEMINARY AVE
Second Line :
City : WOODSTOCK
State : IL
Zip : 60098-2626
Country : US
Telephone Number : 815-338-3590
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2014
Last Update Date : 05/20/2026

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Directions to “ JENNIFER BALLETO LCPC” Practice Location

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