1952022741 NPI number — JADE ALEXUS YUMPING LCSW

Table of content: JADE ALEXUS YUMPING LCSW (NPI 1952022741)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952022741 NPI number — JADE ALEXUS YUMPING LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YUMPING
Provider First Name:
JADE
Provider Middle Name:
ALEXUS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SILER
Provider Other First Name:
JADE
Provider Other Middle Name:
ALEXUS
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1952022741
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/08/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
850 W BARTLETT RD STE 14C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BARTLETT
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60103-4454
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-864-7267
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
850 W BARTLETT RD STE 14C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BARTLETT
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60103-4454
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-864-7267
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/08/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  149.024726 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)