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Organization

JCRX MENTAL HEALTH SERVICES PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JESSICA CATHERINE RODRIGUEX WELLMAKER MA, LCPC (OWNER)
(408) 656-0623
Entity
Organization

Contact information

Practice address
1720 BROADWAY ST, MOUNT VERNON, IL 62864-2930
(408) 656-0623
Mailing address
906 MAPLE ST, MOUNT VERNON, IL 62864-3547
(408) 656-0623

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
09/10/2024
Last updated
09/10/2024
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