Individual provider Active NPI

Jennifer Agnes Lewanczyk-Terenzio, LCSW

  • Clinical Social Worker
  • Lombard, IL
National Provider Identifier
1104684828
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.026709 Issued in IL
Practice address
477 E Butterfield Rd
Lombard, IL 60148-5618
Phone
(872) 228-7243
NPI assigned
Mar 7, 2024
Last updated
Mar 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.026709 IL Primary

Addresses

Primary practice location

477 E Butterfield Rd
Lombard, IL 60148-5618

Mailing address

1630 Red Coach LN
Algonquin, IL 60102-3961
Phone (773) 983-9306

Other practice location 1

1630 Red Coach Ln
Algonquin, IL 60102-3961
Phone (773) 983-9306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149.026709ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1709769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1104684828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 RED COACH LN",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601023961",
            "telephone_number": "773-983-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 E BUTTERFIELD RD",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601485618",
            "telephone_number": "872-228-7243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1630 Red Coach Ln",
            "address_purpose": "LOCATION",
            "city": "Algonquin",
            "state": "IL",
            "postal_code": "601023961",
            "country_code": "US",
            "telephone_number": "773-983-9306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWANCZYK-TERENZIO",
        "first_name": "JENNIFER",
        "middle_name": "AGNES",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-07",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.026709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lombard, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.