JESSICA GILLEN
Complete NPI Record 1235532342
Counselor - Mental Health in Alton, IL
NPI Status: Active since October 02, 2014
Contact Information
2615 EDWARDS ST
ALTON, IL
ZIP 62002
Phone: (618) 462-2331
Fax: (618) 462-2504
Complete NPI Dataset
This page is the complete raw NPPES record for Jessica Gillen, an individual counselor provider in Alton, IL — NPI 1235532342 — presented field by field exactly as filed in the National Plan and Provider Enumeration System, with the official NPPES definition of every field. Unlike the summarized NPI profile, nothing here is interpreted or condensed: each attribute and value appears exactly as recorded in the registry.
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Registry File Document Utilities
- NPI: 1235532342
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: GILLEN
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: JESSICA
- The first name of the provider, if the provider is an individual.
- Provider First Line Business Mailing Address: 2615 EDWARDS ST
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: ALTON
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: IL
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 620023915
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 6184622331
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 6184622504
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 2615 EDWARDS ST
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: ALTON
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: IL
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 620023915
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 6184622331
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 6184622504
- The fax number associated with the location address of the provider being identified.
- Provider Gender Code: F
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 101YM0800X
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 1: Y
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Sole Proprietor: N
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
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