Organization
JESSICA WHELAN LLC
Active
Other names
Holon Inclusive Health System
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA ANN WHELAN (CEO)
(314) 470-1220
Entity
Organization
Contact information
Practice address
207 N MAIN ST STE 109B, COLUMBIA, IL 62236-1755
(314) 470-1220
(833) 914-0432
Mailing address
PO BOX 242, GROVER, MO 63040-0242
(636) 236-5128
(636) 242-5095
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103TC1900X
Counseling Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
174400000X
Specialist
Primary
—
—
183500000X
Pharmacist
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
—
—
2084P0301X
Brain Injury Medicine (Psychiatry & Neurology) Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR1100X
Research Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500089936
—
MO
01
—
6982159
AETNA - MEDICAID
MO
01
—
735518
MCKESSON SUBMITTER ID
ID
Enumeration date
03/21/2020
Last updated
11/19/2021
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