Organization
JACQUELYN E AUGUSTINE PSY.D PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELYN E AUGUSTINE PSYD (PRESIDENT)
(708) 214-2448
Entity
Organization
Contact information
Practice address
1938 E LINCOLN HWY, NEW LENOX, IL 60451-3810
(708) 214-2448
Mailing address
11784 GOLDEN GATE DR, MOKENA, IL 60448-2033
(708) 214-2448
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/26/2022
Last updated
02/22/2022
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