Jodi Petchenik, M.S.W., L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149010494 Issued in IL

Practice address

2726 Hawthorn LN
Wilmette, IL 60091-2140

Phone

(847) 650-4444

NPI assigned

Jan 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Holistic Therapy-Mind, Body, Spirit

  • Clinical Social Worker
  • Northbrook, IL
  • NPI 1982469565
  NPD Authorized official

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1154488179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2726 HAWTHORN LN",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912140",
            "telephone_number": "847-650-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2726 HAWTHORN LN",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912140",
            "telephone_number": "847-650-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETCHENIK",
        "first_name": "JODI",
        "name_prefix": "Ms.",
        "credential": "M.S.W., L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149010494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Nolan LCSW LLC
• Peak Therapeutics, LTD (Peak and Balance Centers of America)
• Joie Pecoraro, LSW
• Pediatric Dentisrty Specialists P.C.
• Pediatric Eye Associates, PC (Pediatric Eye Associates)
• Peter R. Lewy, MD, LTD (Pediatric Associates of the North Shore)
• Nancy E Peter, MSW, LCSW
• Kathleen Philben, PH.D.
• Philip Cook DDS LLC
• Danielle Nicole Phillips, DOT

• Clinical Social Worker in Wilmette, IL
• Providers in Wilmette, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; 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.