Provider Demographics
NPI:1982237137
Name:MARGIS, JENA L (CADC)
Entity Type:Individual
Prefix:MRS
First Name:JENA
Middle Name:L
Last Name:MARGIS
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CROSSROADS COUNSELING AND CARE CENTER
Mailing Address - Street 2:1520 N. ROCK RUN DRIVE, SUITE #14
Mailing Address - City:CREST HILL
Mailing Address - State:IL
Mailing Address - Zip Code:60403
Mailing Address - Country:US
Mailing Address - Phone:618-518-7726
Mailing Address - Fax:
Practice Address - Street 1:CROSSROADS COUNSELING AND CARE CENTER
Practice Address - Street 2:1520 N. ROCK RUN DRIVE, SUITE #14
Practice Address - City:CREST HILL
Practice Address - State:IL
Practice Address - Zip Code:60403
Practice Address - Country:US
Practice Address - Phone:618-518-7726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILCADC32864101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)