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MRS. JACQUELYN A MITRA LCPC
NPI 1619121373
Counselor - Mental Health in Normal, IL

Active since November 07, 2008
405 KAYS DR, SUITE B, NORMAL, IL 61761(309) 862-0064(309) 862-1542 Get Directions Write a Review

NPPES record last updated: February 1, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mrs. Jacquelyn A Mitra Lcpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. JACQUELYN A MITRA LCPC (NPI 1619121373) is an individual mental health provider in Normal, Illinois, licensed in Illinois (180 006966) and active in the NPI registry since November 2008.

NPPES Registry Identity

NPI1619121373
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMRS. JACQUELYN A MITRACredential: LCPC
Location Address405 KAYS DR, SUITE BNormal, IL 61761-1979
Mailing Address405 Kays Dr, Suite BNormal, IL 61761-1979 · (309) 862-0064 · Fax (309) 862-1542
Phone(309) 862-0064
Fax(309) 862-1542
Sole ProprietorNo
Enumeration DateNovember 7, 2008
Last NPPES UpdateFebruary 1, 2010
✔ NPI 1619121373 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in IL · 180 006966
405 KAYS DR, Normal, IL 61761
Open in Google Maps ↗

Other Identifiers 1

Medicare PIN588330IL

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AYRIELLE EHLERS
Counselor (Professional)
405 KAYS DR
NORMAL, IL 61761
McLean County (309) 822-2725
SHERI BETTIS
Counselor (Mental Health)
405 KAYS DR
NORMAL, IL 61761
McLean County (309) 807-5077
HEIDI SIMPSON
Social Worker
405 KAYS DR
NORMAL, IL 61761
McLean County (309) 807-5077
ANNETTE M LARSEN LCPC
Counselor (Professional)
405 KAYS DR
NORMAL, IL 61761
McLean County (309) 888-9979
PATRICK J. CARROLL LCSW
Counselor (Professional)
405 KAYS DR
NORMAL, IL 61761
McLean County (309) 888-9979
LINDA HOKANSON L.C.S.W.
Social Worker (Clinical)
405 KAYS DR, SUITE C
NORMAL, IL 61761
McLean County (309) 664-3130
DAWN MARIE LEEDIE LPCP
Counselor (Professional)
405 KAYS DR, STE B
NORMAL, IL 61761
McLean County (309) 862-0064

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 Jacquelyn Mitra's NPI number?

The NPI number for Jacquelyn Mitra is 1619121373. It was assigned to this individual provider in the NPPES registry on November 7, 2008.

Where is Jacquelyn Mitra located?

Jacquelyn Mitra practices at 405 Kays Dr Suite B, Normal, IL 61761. The listed phone number is (309) 862-0064.

What is Jacquelyn Mitra's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Jacquelyn Mitra was last updated on February 1, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years 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.