| Ms Jennifer Lee Jackson, MA, LCPC | |
|
636 Church St Ste 415, Evanston, IL 60201-4580 | |
| (773) 234-0194 | |
| (773) 676-0111 |
| Full Name | Ms Jennifer Lee Jackson |
|---|---|
| Gender | Female |
| Speciality | Mental Health Counselor |
| Experience | 19 Years |
| Location | 636 Church St Ste 415, Evanston, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134698723 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 180014068 (Illinois) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mental Health Specialty Group Pa | 8921466228 | 726 |
| Entity Name | Mental Health Specialty Group PA |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801472634 PECOS PAC ID: 8921466228 Enrollment ID: O20240911001944 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Jennifer Lee Jackson, MA, LCPC 15217 Lotus Dr, Cleveland, OH 44128-1915 Ph: (216) 956-3767 | Ms Jennifer Lee Jackson, MA, LCPC 636 Church St Ste 415, Evanston, IL 60201-4580 Ph: (773) 234-0194 |
Anneliese Michelle Kranz, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1613 Church Street, Evanston, IL 60201 Phone: 717-385-9214 |
Cara Eliana Fisher Wellvang, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1702 Sherman Ave, Evanston, IL 60201 Phone: 847-425-9708 |
Melissa Chavez, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2100 Ridge Ave, Evanston, IL 60201 Phone: 847-866-2977 |
Margot Torossian, Counselor Medicare: Not Enrolled in Medicare Practice Location: 911 Church St, Evanston, IL 60201 Phone: 847-919-9096 Fax: 847-919-9096 |
Luke Maxwell Drenter, Counselor Medicare: Not Enrolled in Medicare Practice Location: 800 Austin St., West Tower, Suite 312, Evanston, IL 60202 Phone: 812-406-7735 |
Mrs. Eileen H Glenn, L.C.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 708 Church St Ste 247, Evanston, IL 60201 Phone: 847-733-9661 Fax: 847-733-1571 |
Ms. Susan G Rowe, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1830 Sherman Ave, Suite 303, Evanston, IL 60201 Phone: 847-542-2300 |