Individual provider Active NPI

Jodi Ann Bova, LCPC

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1154672012
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.008346 Issued in IL
Practice address
3437 S Union Ave
#2F
Chicago, IL 60616-3426
Phone
(312) 401-9589
NPI assigned
Oct 1, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180.008346 IL Primary

Addresses

Primary practice location

3437 S Union Ave
#2F
Chicago, IL 60616-3426

Mailing address

3437 S Union Ave
#2F
Chicago, IL 60616-3426
Phone (312) 401-9589

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
180.008346ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1154672012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3437 S UNION AVE",
            "address_2": "#2F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163426",
            "telephone_number": "312-401-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3437 S UNION AVE",
            "address_2": "#2F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163426",
            "telephone_number": "312-401-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVA",
        "first_name": "JODI",
        "middle_name": "ANN",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-01",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.008346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.