CMS-1500 Box 24J / 33a • NPI
1972040210
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
101YP1600X
Licensed & Credentialed Counselor, Pastoral
Box 32 Service Location & ZIP+4
5655 KINGSBURY AVE APT 909, SAINT LOUIS, MO, 63112-1874
✓ 9-Digit EDI 837 ZIP+4 (63112-1874)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1972040210 (JACQUELINE JUANITA MADISON, DMin,MA, CAPS, LPC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1972040210 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | JACQUELINE JUANITA MADISON, DMin,MA, CAPS, LPC |
| Plain-English Specialty | Licensed & Credentialed Counselor, Pastoral NUCC Code: 101YP1600X (Counselor, Pastoral) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 5655 KINGSBURY AVE APT 909, SAINT LOUIS, MO, 63112-1874 |
| Practice Telephone / Fax | Tel: (314) 740-0903 |
| Administrative Mailing Address | 5343 BELLEVILLE CROSSING ST # 2079, BELLEVILLE, IL, 62226-3108 |
| Enumeration & Last Sync | Enumerated: 2017-01-25 | CMS Record Updated: 2023-05-22 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (101YP1600X)
What Does Taxonomy Code 101YP1600X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 101YP1600X translates to:
"Licensed & Credentialed Counselor, Pastoral"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (JACQUELINE JUANITA MADISON, DMin,MA, CAPS, LPC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
101Y00000X — CounselorPlain English: Licensed & Credentialed Counselor | State: N/A | License: Verified | Primary: Secondary |
101YM0800X — Counselor, Mental HealthPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor | State: IL | License: 178.012744 | Primary: Secondary |
101YP1600X — Counselor, PastoralPlain English: Licensed & Credentialed Counselor, Pastoral | State: N/A | License: Verified | Primary: Secondary |
171400000X — Health & Wellness CoachPlain English: Licensed & Credentialed Health & Wellness Coach | State: N/A | License: Verified | Primary: Secondary |
171400000X — Health & Wellness CoachPlain English: Licensed & Credentialed Health & Wellness Coach | State: N/A | License: 1090 | Primary: Secondary |
101YP1600X — Counselor, PastoralPlain English: Licensed & Credentialed Counselor, Pastoral | State: IL | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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