JACQUELIN DIANE EJKA (NPI# 1083070940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083070940 |
| Entity Type | Individual |
| Full Name | JACQUELIN DIANE EJKA |
| Credential | LCSW |
| Practice Address |
1003 N Cummings Ln Washington IL 61571-9646 |
| Practice Telephone | 3094441000 |
| Practice Fax Number | 3094447000 |
| Mailing Telephone | 3094441000 |
| Mailing Fax Number | 3094447000 |
| Enumeration Date | 2016-01-07 |
| Last Update Date | 2016-01-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149.014899 | IL | Behavioral Health & Social Service Providers |
| Street Address |
1003 N CUMMINGS LN |
| City | WASHINGTON |
| State | IL |
| Zip Code | 61571-9646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942558655 | Aimee Jeannette Ladd | Psychologist | 1003 N Cummings Ln, Washington, IL 61571-9646 | 2012-08-28 |
| 1871106377 | Tonya Koenigstein | Counselor | 1003 N Cummings Ln, Washington, IL 61571-9646 | 2020-08-25 |
| 1386283562 | Anna Dusza | Counselor | 1003 N Cummings Ln, Washington, IL 61571-9646 | 2020-01-05 |
| 1457996324 | Kirby O'brien | Counselor | 1003 N Cummings Ln, Washington, IL 61571-9646 | 2019-11-14 |
| 1558830711 | Victoria Demler Kamhi | Counselor | 1003 N Cummings Ln, Washington, IL 61571-9646 | 2018-11-17 |
| 1467949487 | Marie L Mullins | Counselor | 1003 N Cummings Ln, Washington, IL 61571-9646 | 2018-04-16 |
| 1871046276 | Melissa Sallee | Counselor | 1003 N Cummings Ln, Washington, IL 61571-9646 | 2016-08-02 |
| 1063869634 | Brennen Joseph | Counselor | 1003 N Cummings Ln, Washington, IL 61571-9646 | 2016-05-24 |
| 1487022513 | Renee Ann Patton | Counselor | 1003 N Cummings Ln, Washington, IL 61571-9646 | 2015-09-06 |
| 1124435474 | Shelley Jo Green | Behavioral Analyst | 1003 N Cummings Ln, Washington, IL 61571-9646 | 2014-07-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164904504 | Kelly Hornberger | Physical Therapist | 1201 Newcastle Rd., Washington, IL 61571 | 2018-09-01 |
| 1073050407 | Jillyn Cross | Occupational Therapist | 14 Oxford Court, Washington, IL 61571 | 2017-01-24 |
| 1639410772 | Stephen L Dejaynes | Counselor | 100 Hillcrest Drive, Washington, IL 61571 | 2013-03-14 |
| 1184998692 | One Counseling and Wellness | Counselor | 1003 North Cummings Lane, Washington, IL 61571 | 2012-03-01 |
| 1871878371 | M Lisa Kim | Pharmacist | 1700 Saddleridge Ct, Washington, IL 61571 | 2011-10-15 |
| 1073805156 | Skill Sprout International | Behavioral Analyst | 102 Walnut Street, Washington, IL 61571 | 2011-05-09 |
| 1659600948 | Skill Sprout, LLC | Behavioral Analyst | 128 Washington Square, Washington, IL 61571 | 2009-12-15 |
| 1700024916 | Julie Adams | Developmental Therapist | 700 S. Elm, Washington, IL 61571 | 2009-01-26 |
| 1851595128 | Michael John Herman | Dentist | 106 So Cummings Lane, Washington, IL 61571 | 2007-06-12 |
| 1861539132 | Gary Lee Cunningham | Dentist | 5 Laurel Ct., Washington, IL 61571 | 2007-01-30 |
| Find all providers in zip 61571 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487254769 | Ayana E Thompson | Social Worker | 706 Burns St Se, Washington, DC 20019-4913 | 2020-10-27 |
| 1265030282 | Amy Killy | Social Worker | 5402 Connecticut Ave Nw Ste 102, Washington, DC 20015-2830 | 2020-10-12 |
| 1144828385 | Ann Morrison | Social Worker | 5333 Connecticut Ave Nw Apt 528, Washington, DC 20015-1895 | 2020-10-10 |
| 1225645591 | Rs Davis Health & Wellness, LLC | Social Worker | 3200 Martin Luther King Jr Ave Se, Washington, DC 20032-1538 | 2020-09-30 |
| 1114534716 | Beth Anne Henson | Social Worker | 2717 Unicorn Ln Nw, Washington, DC 20015-2233 | 2020-09-28 |
| 1588271407 | Andrew Thomas | Social Worker | 801 Pa Ave Se, Washington, DC 20003-2167 | 2020-09-24 |
| 1043826324 | Wellness Reset Solutions LLC | Social Worker | 255 Carroll St Nw Apt 552, Washington, DC 20012-2093 | 2020-09-21 |
| 1487266995 | Martha Johnson | Social Worker | 1555 Connective Ave Nw, #500w, Washington, DC 20036 | 2020-08-18 |
| 1538779863 | Moore Therapeutic and Consulting Services | Social Worker | 1600 Maryland Ave Ne Apt 257, Washington, DC 20002-7662 | 2020-08-02 |
| 1992313266 | Paula Nicole Thomason | Social Worker | 4407 2nd St Ne Apt 2, Washington, DC 20011-5142 | 2020-07-22 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 61571 |
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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.