Jonathan Smith, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.009490 Issued in IL

Practice address

5412 N Clark St Ste 220
Chicago, IL 60640-1272

Phone

(773) 985-8746

NPI assigned

Jul 20, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Andersonville Psychology, PC

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1962924829
  NPD Authorized official
• Chicago Mindful Psychotherapy, Inc.

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1871863282
  NPD
• Live Oak, Inc.

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1629141163
  NPD (past)

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1124403100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5412 N CLARK ST STE 220",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401272",
            "telephone_number": "773-985-8746",
            "fax_number": "773-880-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5412 N CLARK ST STE 220",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401272",
            "telephone_number": "773-985-8746"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5537 N Clark St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606401222",
            "country_code": "US",
            "telephone_number": "773-985-8746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JONATHAN",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-20",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.010187",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Smith
• Jessica Smith, PSYD
• Jessica Lauran Smith
• Jo Anne Smith, MSW LCSW
• John Buchanan Smith III
• Jordan Smith, LCSW
• Jordan Logan Smith
• Joseph Smith II, PA-C
• Joy Smith, PHARMD
• Joyce Marie Smith, M.D.

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.