Provider Demographics
NPI:1275704090
Name:HEMMELE, JEWEL KRISTINE (LCPC)
Entity Type:Individual
Prefix:MS
First Name:JEWEL
Middle Name:KRISTINE
Last Name:HEMMELE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 SW WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61602-1417
Mailing Address - Country:US
Mailing Address - Phone:309-676-2400
Mailing Address - Fax:309-676-6037
Practice Address - Street 1:330 SW WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61602-1417
Practice Address - Country:US
Practice Address - Phone:309-676-2400
Practice Address - Fax:309-676-6037
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health