MR. JASON D. SPENCER (NPI# 1194003574) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194003574 |
| Entity Type | Individual |
| Full Name | MR. JASON D. SPENCER |
| Credential | LCPC |
| Practice Address |
1600 E. Lincoln Highway Suite D Dekalb IL 60115-3905 |
| Practice Telephone | 6308032499 |
| Mailing Telephone | 6308032499 |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2015-12-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
180007800 | IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | LICENSE NUMBER | 180007800 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558613943 | Jason Martin Spencer | Physical Therapist | 90a Clark Blvd, Tupelo, MS 38804-2801 | 2012-10-09 |
| 1316110927 | Jason Bradley Spencer | Emergency Medicine | 6019 Walnut Grove Rd, Memphis, TN 38120-2113 | 2008-04-04 |
| 1417175464 | Jason Spencer | Pharmacist | 4109 Eva Rd, Eva, AL 35621-7648 | 2007-04-23 |
| 1700995354 | Jason Chauncey Spencer | Physician Assistant | 8761 Perimeter Park Blvd Ste 106, Jacksonville, FL 32216-6397 | 2006-08-29 |
| Street Address |
1600 E. LINCOLN HIGHWAY SUITE D |
| City | DEKALB |
| State | IL |
| Zip Code | 60115-3905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598372179 | Megan Erhart | Counselor | 304 N. 6th Street, Dekalb, IL 60115 | 2020-09-28 |
| 1689141616 | Stephanie Klewin | Psychologist | 631 S 1st Street, Dekalb, IL 60115 | 2018-10-29 |
| 1164902219 | Kimberly Ann Hart | Counselor | 290 N. Annie Glidden Drive, Gh 416, Niu, Dekalb, IL 60115 | 2018-08-17 |
| 1497235824 | Cory David Michael Hayden | Specialist/Technologist | 175 Yordon Center (niu Athletic Training), Dekalb, IL 60115 | 2018-08-15 |
| 1154807808 | Michael John Borak | Pharmacist | 975 S Annie Glidden Road, Schnucks Market Inc, Dekalb, IL 60115 | 2018-07-16 |
| 1184125841 | Candace Schroeffel | Student in an Organized Health Care Education/Training Program | 520 Garden Rd, Dekalb, IL 60115 | 2018-02-27 |
| 1033627583 | Hannah M Studebaker | Massage Therapist | 3266 Sycamore Road, Dekalb, IL 60115 | 2018-01-18 |
| 1649700238 | Jennifer Mangino | Behavioral Analyst | 138 Berkshire Dr, Dekalb, IL 60115 | 2017-06-15 |
| 1003346628 | Victoria Tullock | Counselor | 631 South First St., Dekalb, IL 60115 | 2017-06-15 |
| 1194263848 | Brianna Kraft | Specialist/Technologist | 900 Crane Dr, Dekalb, IL 60115 | 2017-02-02 |
| Find all providers in zip 60115 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487010542 | Patrick Mcmillion | Counselor | 1609 Mayflower Dr, Dekalb, IL 60115-1723 | 2016-01-05 |
| 1598133779 | Kimberly K. Johnson | Counselor | 1543 Stonefield Dr, Dekalb, IL 60115-8906 | 2015-09-04 |
| 1912387754 | Lisa Ann Jensen | Counselor | 1415 Lewis St, Dekalb, IL 60115-2631 | 2015-06-07 |
| 1093137440 | Matthew Sprong | Counselor | 2500 N Annie Glidden Rd, Suite F, Dekalb, IL 60115-1310 | 2014-01-19 |
| 1487823977 | Amanda Mccarthy | Counselor | Allied Health and Communicative Disorders, 323j Wirtz Hall Northern Illinois University, Dekalb, IL 60115 | 2008-02-28 |
| 1477606531 | Christopher Joseph Gough | Counselor | 400 East Hillcrest Drive, Suite 100a, Dekalb, IL 60115 | 2007-01-19 |
| 1194880807 | Paul A Legler | Counselor | 14 Health Services, Dekalb, IL 60115 | 2006-12-22 |
| 1487719100 | Joseph Puleo IIi | Counselor | 14 Health Services Dr, Dekalb, IL 60115 | 2006-12-22 |
| 1144393497 | Amylynn M Weiten | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2006-11-16 |
| 1154408565 | Suzanne Marie Krzyzek | Counselor | 444 E Hillcrest Dr, Suite 210, Dekalb, IL 60115-2498 | 2006-11-01 |
| Find all providers in DEKALB | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.