Individual provider · Type 1 NPI
Jessica M. Crunkleton
Mental Health Counselor · Belleville, IL
NPI number
1487308102
Active
Practice location
2427 Pro Tour Dr
Belleville, IL 62220-4853
Mailing address
5343 Belleville Crossing St # 1015
Belleville, IL 62226-3108
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor | 101YM0800X | 2021028230 (MO) |
| Mental Health Counselor | 101YM0800X | 35002024A (IN) |
| Mental Health Counselor | 101YM0800X | 39003344A (IN) |
| Mental Health Counselor | 101YM0800X | 2021028229 (MO) |
| Mental Health Counselor Primary | 101YM0800X | 180.014386 (IL) |
Mental Health Counselor: Definition to come...
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About NPI 1487308102
Jessica M. Crunkleton's National Provider Identifier is 1487308102, issued on Feb 10, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Belleville, IL. The record was last updated on Jul 16, 2022.