JACQUELYN EILEEN AUGUSTINE (NPI# 1619286986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619286986 |
| Entity Type | Individual |
| Full Name | JACQUELYN EILEEN AUGUSTINE |
| Credential | PSY.D. |
| Practice Address |
15010 S Ravinia Ave Suite 19 Orland Park IL 60462-3162 |
| Mailing Address |
918 N 16th Ave Melrose Park IL 60160-3831 |
| Practice Telephone | 7084033200 |
| Mailing Telephone | 7082142448 |
| Enumeration Date | 2010-10-04 |
| Last Update Date | 2010-10-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
15010 S RAVINIA AVE SUITE 19 |
| City | ORLAND PARK |
| State | IL |
| Zip Code | 60462-3162 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295736635 | Martins Adeoye LLC | Psychiatry & Neurology | 15010 S Ravinia Ave, Suite 15, Orland Park, IL 60462-3162 | 2005-08-09 |
| 1578181251 | Andrenia Maria Parker | Counselor | 15010 S Ravinia Ave, Orland Park, IL 60462-3162 | 2020-07-09 |
| 1407231715 | Nicholas Mcdonald | Counselor | 15010 S Ravinia Ave, Orland Park, IL 60462-3162 | 2015-07-28 |
| 1124460902 | Erica Ray, Inc | Counselor | 15010 S Ravinia Ave, Suite 15, Orland Park, IL 60462-3162 | 2013-07-22 |
| 1780936856 | Chicago Neurobehavior Specialists | Psychologist | 15010 S Ravinia Ave, Suite 14, Orland Park, IL 60462-3162 | 2012-10-12 |
| 1316219371 | Jennifer Galle Ma Lcpc Inc | Counselor | 15010 S Ravinia Ave, Suite 15, Orland Park, IL 60462-3162 | 2012-02-06 |
| 1689966541 | Christine Anne Gesiorski | Counselor | 15010 S Ravinia Ave, Ste 15, Orland Park, IL 60462-3162 | 2011-05-11 |
| 1043517600 | Joy Prepejchal Psyd Sc | Clinic/Center | 15010 S Ravinia Ave, Suite 15, Orland Park, IL 60462-3162 | 2011-02-17 |
| 1033410477 | Elemental Center Ltd. | Psychiatry & Neurology | 15010 S Ravinia Ave, Suite 15, Orland Park, IL 60462-3162 | 2010-11-16 |
| 1154650042 | Orland Family Institute LLC | Psychiatry & Neurology | 15010 S Ravinia Ave, Suite 15, Orland Park, IL 60462-3162 | 2009-12-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083257331 | Stephanie Slager | Behavioral Analyst | 8430 W 135th St., Orland Park, IL 60462 | 2019-10-18 |
| 1730652587 | Nancy Lynch | Speech-Language Pathologist | 15100 S 94th Ave Orland School District 135, Orlond Park, IL 60462 | 2019-01-04 |
| 1932681327 | Alyssa Avant | Speech-Language Pathologist | 8851 W 151st St, Orland Park, IL 60462 | 2018-08-31 |
| 1922588110 | Pain Specialists of Greater Chicago S C | Pain Medicine | 15300 West Ave Ste C213, Orland Park, IL 60462 | 2018-08-16 |
| 1689168478 | S- R&r Counseling Inc. | Counselor | 9750 Crescent Park Cir Unit 306, Orland Park, IL 60462 | 2018-06-15 |
| 1104372952 | Amy Blanks | Nurse Anesthetist, Certified Registered | 13959 95th Avenue, Orland Park, IL 60462 | 2016-08-31 |
| 1740632454 | Anna S Wang | Optometrist | 14494 John Humphrey Dr, Orland Park, IL 60462 | 2016-07-06 |
| 1750739793 | Carolyn Sluis | Pharmacist | 9352 W 159th Street, Orland Park, IL 60462 | 2016-06-01 |
| 1164882262 | Caring Hands Group Home of Il, Inc. | Community/Behavioral Health | 14475 John Humphrey Dr., Orland Park, IL 60462 | 2016-03-02 |
| 1639539760 | Frazierworks Community Care, Inc. | In Home Supportive Care | 14475 John Humphrey Dr Suite 300, Orland Park, IL 60462 | 2016-03-02 |
| Find all providers in zip 60462 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689168478 | S- R&r Counseling Inc. | Counselor | 9750 Crescent Park Cir Unit 306, Orland Park, IL 60462 | 2018-06-15 |
| 1841601150 | Jennifer Crumb Perez | Counselor | 1500 Ravinia Pl Ste 1c, Orland Park, IL 60462-3963 | 2014-05-09 |
| 1841312808 | Huda Abuasi | Counselor | 11227 Distinctive Dr, Suite C, Orland Park, IL 60467-9458 | 2007-04-03 |
| 1871649335 | Katie Bridget Dimperio | Counselor | 200 Ravinia Ave, Orland Park, IL 60462 | 2007-01-26 |
| 1871012880 | Vilma Matthews | Counselor | 15127 S 73rd Ave Ste G, Orland Park, IL 60462-3425 | 2017-09-12 |
| 1285036491 | Breathe | Counselor | 15255 S 94th Ave, Orland Park, IL 60462-3800 | 2014-09-18 |
| 1154689396 | Kevin Curtis Watson | Counselor | 60 Orland Square Dr Ste 203, Orland Park, IL 60462-6523 | 2012-04-25 |
| 1316219371 | Jennifer Galle Ma Lcpc Inc | Counselor | 15010 S Ravinia Ave, Suite 15, Orland Park, IL 60462-3162 | 2012-02-06 |
| 1396035796 | Michael Geraci | Counselor | 15127 S 73rd Ave, Suite G, Orland Park, IL 60462-4398 | 2011-04-19 |
| 1932414026 | Ashley Rae Cosentino | Counselor | 700 Ravinia Pl, Orland Park, IL 60462-3700 | 2010-08-12 |
| Find all providers in ORLAND PARK | ||||
| City | ORLAND PARK |
| Zip Code | 60462 |
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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.