MRS. JULIE W TENNILL


Address: 1515 W Walnut St, Building 1, Jacksonville, IL 62650-1150
Phone: 2172457275

MRS. JULIE W TENNILL (NPI# 1629086913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629086913
Entity Type Individual
Full Name MRS. JULIE W TENNILL
Credential MSW, ACSW, LCSW
Practice Address 1515 W Walnut St
Building 1
Jacksonville
IL 62650-1150
Practice Telephone 2172457275
Practice Fax Number 2172457427
Mailing Telephone 2172457275
Mailing Fax Number 2172457427
Enumeration Date 2006-08-03
Last Update Date 2020-04-07
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1041C0700X Social Worker
Specialization: Clinical
149001875 IL Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
IL 681484 HEALTHLINK 01
IL BC/BS 06932018 01
IL HEALTH ALLIANCE 100842 01
IL IL STATE LICENSE 149001875 01
IL IRS TAX ID 41-2267080 01

Office Location

Street Address 1515 W WALNUT ST
BUILDING 1
City JACKSONVILLE
State IL
Zip Code 62650-1150

Providers in the same location

NPI Name Taxonomy Address Enumeration
1558333633 Allen G Gerberding Family Medicine 1515 W Walnut St, Jacksonville, IL 62650-1150 2006-02-03
1740777093 Tamara Breckon Nurse Practitioner 1515 W Walnut St, Jacksonville, IL 62650 2018-04-21
1629465414 Hshs Medical Group Inc Durable Medical Equipment & Medical Supplies 1515 W Walnut St, Suite 12, Jacksonville, IL 62650-1150 2015-04-20
1164848750 Smile Experts Dental Associates Exclusive Provider Organization 1515 W Walnut St, Jacksonville, IL 62650-1150 2014-03-06
1609177005 Madhusudan Vallala M.d., S.c. Internal Medicine 1515 W Walnut St, Jacksonville, IL 62650-1150 2010-11-16
1295068856 Eldon G. Barrowes Dentist 1515 W Walnut St, Bldg. #3, Jacksonville, IL 62650-1150 2009-09-15
1962650150 Lynch Family Dentistry, P.C. Clinic/Center 1515 W Walnut St, Building 5, Jacksonville, IL 62650-1150 2008-09-03
1891960753 Ronald R Lynch Dmd Ltd Clinic/Center 1515 W Walnut St, Jacksonville, IL 62650-1150 2008-04-22
1295952422 Robert A. Krueger, D.d.s., Ltd. Dentist 1515 W Walnut St, #8, Jacksonville, IL 62650-1150 2007-04-19
1477677995 Foot and Ankle Associates of Central Illinois LLC Durable Medical Equipment & Medical Supplies 1515 W Walnut St, Suite 12, Jacksonville, IL 62650-1150 2007-03-19
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1134768708 Stephanie Lee Mabus Occupational Therapy Assistant 873 Gorve St, Jacksonville, IL 62650 2019-12-31
1285281071 Sharshon Pharmacy Inc Pharmacy 154 W Morton Ave, Jacksonville, IL 62650 2019-08-26
1992275499 Brittany Ruth Helmich Counselor 340 W. State St., Jacksonville, IL 62650 2018-11-28
1811391782 Rodney E. Overstreet Hearing Instrument Specialist 1521 W. Walnut, Jacksonville, IL 62650 2014-10-21
1407979818 Jan Ala Speech-Language Pathologist 1111 W Morton, Speechworks, Jacksonville, IL 62650 2007-04-09
1083787592 Eldon G Barrowes Dds & Assoc PC Dentist 1515 West Walnut, Bldg #3, Jacksonville, IL 62650 2006-11-15
1194895979 Joseph J Kozma Internal Medicine 1440 West Walnut, Jacksonville, IL 62650 2006-11-08
1740350529 Susan Weller Dentist 1614 West Lafayette Avenue, Jackson, IL 62650 2006-11-08
1659467793 Shawn M Fry Family Medicine 610 N. Westgate, Jacksonville, IL 62650 2006-10-05
1518050061 Ward Richard Dunseth II Nurse Anesthetist, Certified Registered 1400 W Walnut, Jacksonville, IL 62650 2006-10-02
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Taxonomy Information

Taxonomy Code 1041C0700X
Grouping Behavioral Health & Social Service Providers
Classification Social Worker
Specialization Clinical

Taxonomy Definition

A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1336748193 Sophia Venditti Social Worker 2598 Post St # 1, Jacksonville, FL 32204-4256 2020-10-22
1629676093 My Journey, LLC Social Worker 13453 N Main St Ste 204, Jacksonville, FL 32218-2773 2020-10-16
1104423524 Sonya Young Social Worker 920 Bridier St, Jacksonville, FL 32206-5904 2020-10-08
1043823115 Sierra Lashonda Murray Social Worker 9246 Thunderbolt Dr, Jacksonville, FL 32221-8052 2020-08-28
1235741901 Deidra Lewis Social Worker 4480 Deerwood Lake Pkwy Unit 134, Jacksonville, FL 32216-2255 2020-08-23
1497365456 Darlene Denise Rolle- Cargill Social Worker 14050 Integra Dr Apt 420, Jacksonville, FL 32218-2592 2020-08-05
1689282626 Andrea Kristin Perkinson Social Worker 128 Plow Point Ln, Jacksonville, NC 28546-9591 2020-07-15
1255956371 Noel Roman Social Worker 11775 Carson Lake Dr W, Jacksonville, FL 32221-3812 2020-06-15
1285257535 Phaith Coaching & Counseling, LLC Social Worker 4940 Emerson St, Jacksonville, FL 32207-4963 2020-05-21
1407478613 Mara's Lighthouse Counseling Center, LLC Social Worker 6015 Morrow St E Ste 114, Jacksonville, FL 32217-2125 2020-05-11
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Competitor

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City JACKSONVILLE
Zip Code 62650

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Dataset Information

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.

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