NICHOLE JETERS LCPC
NPI 1174770648
Counselor - Mental Health in Carbondale, IL
About Nichole Jeters Lcpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NICHOLE JETERS LCPC (NPI 1174770648) is an individual mental health provider in Carbondale, Illinois, licensed in Illinois (180009521) and active in the NPI registry since August 2008. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2012).
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Secondary Practice Locations 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Nichole Jeters Lcpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Nichole Jeters reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Carbondale, IL 62901
- Reassigned Medicare billing, Illinois enrollment
- 702 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CARBONDALE, IL 62901
CARBONDALE, IL 62901
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Nichole Jeters's NPI number?
The NPI number for Nichole Jeters is 1174770648. It was assigned to this individual provider in the NPPES registry on August 26, 2008. The provider is also known as Nichole King Lcpc.
Where is Nichole Jeters located?
Nichole Jeters practices at 405 W Jackson St, Carbondale, IL 62901. The listed phone number is (618) 549-0721.
What is Nichole Jeters's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Nichole Jeters enrolled in Medicare?
Yes. Nichole Jeters is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Nichole Jeters's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Nichole Jeters reassigns Medicare benefits to Southern Illinois Medical Services, Nfp (Carbondale, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nichole Jeters's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Nichole Jeters accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Medica, Oscar Health and UnitedHealthcare list Nichole Jeters as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Nichole Jeters was last updated on March 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Nichole Jeters, LCPC · NPI 1174770648
Mental Health provider in Carbondale, Illinois. Individual provider, active in the CMS NPPES registry since August 26, 2008.
## Identity
- **NPI:** 1174770648 (Entity type: Individual)
- **Enumerated:** August 26, 2008
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 180009521 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 405 W JACKSON ST, Carbondale, IL 62901-1462
- **Phone:** (618) 549-0721 · **Fax:** (618) 457-0469
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Southern Illinois Medical Services, Nfp (NPI 1770656837, Carbondale, IL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2012
## Record status
- **NPPES last updated:** March 6, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1174770648) · Data from the CMS NPPES public registry.