JACQUELYN EILEEN AUGUSTINE PSY.D.
NPI 1619286986
Counselor in Naperville, IL

Q: What is Jacquelyn Augustine's NPI number?

The NPI number for Jacquelyn Augustine is 1619286986. It was assigned to this individual provider in the NPPES registry on October 4, 2010.

Q: What is Jacquelyn Augustine's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Q: Is Jacquelyn Augustine enrolled in Medicare?

No. Jacquelyn Augustine has opted out of Medicare through February 5, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Active since October 04, 2010Opted out of Medicare · through Feb 5, 2028

1415 BOND ST STE 127, NAPERVILLE, IL 60563(630) 355-9002 Get Directions Write a Review

NPPES record last updated: January 17, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Jacquelyn Eileen Augustine Psy.d. NPPES

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

JACQUELYN EILEEN AUGUSTINE PSY.D. (NPI 1619286986) is an individual counselor in Naperville, Illinois and active in the NPI registry since October 2010. She has opted out of Medicare through February 5, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1619286986

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameJACQUELYN EILEEN AUGUSTINECredential: PSY.D.

Location Address1415 BOND ST STE 127Naperville, IL 60563-2769

Mailing Address1415 Bond StNaperville, IL 60563-2388 · (630) 355-9002

Phone(630) 355-9002

Sole ProprietorYes

Enumeration DateOctober 4, 2010

Last NPPES UpdateJanuary 17, 2022

NPPES CertifiedJanuary 17, 2022

✔ NPI 1619286986 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

Definition

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.

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 071008317 (IL)

1415 BOND ST STE 127, Naperville, IL 60563

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Jacquelyn Eileen Augustine Psy.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 5, 2016 through February 5, 2028.

Opt-Out Effective DateFebruary 5, 2016

Opt-Out In Effect ThroughFebruary 5, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

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Other Providers at the Same Location NPPES 12

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

KRISTEN GULLIVER

Psychologist (Clinical)