Individual provider · Type 1 NPI

Jesse Alexis Medina

Counselor · Rockford, IL

NPI number 1831655679 Active

Practice location

1601 University Dr
Rockford, IL 61107-5317

Call (815) 391-1000 Map

Mailing address

1021 N Mulford Rd
Rockford, IL 61107-3877

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XNone listed

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.

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About NPI 1831655679

Jesse Alexis Medina's National Provider Identifier is 1831655679, issued on Feb 18, 2019. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Rockford, IL. The record was last updated on Feb 18, 2019.