Individual provider Active NPI

Jaime Lynn Scranton, LCSW

  • Clinical Social Worker
  • Bolingbrook, IL
National Provider Identifier
1013609387
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149013776 Issued in IL
Practice address
1077 Churchill Dr
Bolingbrook, IL 60440-1451
Phone
(630) 673-5634
NPI assigned
May 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 149013776 IL
Clinical Social Worker 1041C0700X 149013776 IL Primary

Addresses

Primary practice location

1077 Churchill Dr
Bolingbrook, IL 60440-1451

Mailing address

1077 Churchill Dr
Bolingbrook, IL 60440-1451
Phone (630) 673-5634

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240916002429 IL Practitioner - Clinical Social Worker 9335680586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fash Counseling IncGroup PAC ID 4183003056, 4 clinicians

Practice addresses (Care Compare)

215 Remington Blvd
Suite G
Bolingbrook, IL 60440-3663
Phone (630) 410-9578

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149013776ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fash Counseling Inc. CurrentSince Aug 1, 2024 Accepting new patients

Locations

215 Remington Blvd
Ste G
Bolingbrook, IL 60440
Phone (630) 410-9578

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1013609387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1077 CHURCHILL DR",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401451",
            "telephone_number": "630-673-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1077 CHURCHILL DR",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401451",
            "telephone_number": "630-673-5634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCRANTON",
        "first_name": "JAIME",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "IL",
            "license": "149013776",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149013776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.