NPIMap

Organization Active NPI

Jamie Mirocha

  • Clinical Social Worker
  • Plainfield, IL
National Provider Identifier
1164806279
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149017464 Issued in IL
Legal business name
JAMIE MIROCHA
Practice address
24012 W Renwick Rd Ste 204a
Plainfield, IL 60544-8733
Phone
(815) 676-4688
Fax
(815) 676-4498
NPI assigned
Jul 17, 2015
Last updated
Jul 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Authorized official

Name
Jamie Mirocha, LCSW, CADCNPI 1982080214
Title
Therapist
Phone
(815) 676-4688

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149017464 IL Primary

Addresses

Primary practice location

24012 W Renwick Rd Ste 204a
Plainfield, IL 60544-8733

Mailing address

24012 W Renwick Rd Ste 204a
Plainfield, IL 60544-8733

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437091200000",
    "number": "1164806279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24012 W RENWICK RD STE 204A",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605448733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24012 W RENWICK RD STE 204A",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605448733",
            "telephone_number": "815-676-4688",
            "fax_number": "815-676-4498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMIE MIROCHA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A",
        "authorized_official_last_name": "MIROCHA",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "815-676-4688",
        "authorized_official_credential": "LCSW, CADC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149017464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.