Active NPI
Jean K Tiernan, LCSW, CADC
- Counselor
- Elk Grove Village, IL
National Provider Identifier
1124246871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1001 Rohlwing Rd
Elk Grove Village, IL 60007-3217 - Phone
- (847) 524-8800
- NPI assigned
- Apr 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.017623 | IL | |
| Counselor | 101Y00000X | Primary | ||
| Clinical Social Worker | 1041C0700X | 6801108606 | MI |
Addresses
Primary practice location
1001 Rohlwing Rd
Elk Grove Village, IL 60007-3217
Mailing address
PO Box 115
Shingleton, MI 49884-0115
Phone (847) 894-4919
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
| License | State | Type | Specialty |
|---|---|---|---|
| 149.017623 | IL | MD | Clinical Social Worker |
| 6801108606 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697587200000",
"number": "1124246871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 115",
"city": "SHINGLETON",
"state": "MI",
"postal_code": "498840115",
"telephone_number": "847-894-4919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 ROHLWING RD",
"city": "ELK GROVE VILLAGE",
"state": "IL",
"postal_code": "600073217",
"telephone_number": "847-524-8800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIERNAN",
"first_name": "JEAN",
"middle_name": "K",
"credential": "LCSW, CADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-20",
"last_updated": "2023-10-18",
"certification_date": "2023-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.017623",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801108606",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove Village, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.