JESSICA M CRUNKLETON NPI 1487308102

NPI Information

NPI: 1487308102
Provider Name: JESSICA M CRUNKLETON
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
2427 PRO TOUR DR
BELLEVILLE, IL
ZIP 62220
Phone: (219) 386-6645
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Jessica M Crunkleton is a mental health counselor in Belleville, IL. Jessica M Crunkleton NPI is 1487308102. The provider is registered as an individual entity type and is a multiple single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2427 PRO TOUR DR
BELLEVILLE, IL
ZIP 62220-853
Phone: (219) 386-6645

The enumeration date for this NPI number is 2/10/2022 and was last updated on 7/16/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	2021028230	MISSOURI	No
2	101YM0800X	Counselor	Mental Health	35002024A	INDIANA	No
3	101YM0800X	Counselor	Mental Health	39003344A	INDIANA	No
4	101YM0800X	Counselor	Mental Health	2021028229	MISSOURI	No
5	101YM0800X	Counselor	Mental Health	180.014386	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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