Jeremy Stern, LCSW, LPHA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149017295 Issued in IL

Practice address

2943 W Fargo Ave
Chicago, IL 60645-1222

Phone

(713) 875-0890

NPI assigned

Sep 24, 2014

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)

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.

• Stern Wellness PLLC

  • Clinical Social Worker
  • Houston, TX
  • NPI 1427812775
  NPD Authorized official

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1184026932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2943 W FARGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606451222",
            "telephone_number": "713-875-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2943 W FARGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606451222",
            "telephone_number": "713-875-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "JEREMY",
        "credential": "LCSW, LPHA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-24",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150014041",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149017295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Stern, M.D.
• Dena Stern, MS CCC SLP
• Elissa Lauren Stern, M.D.
• Francisca Stern
• Janice E Stern, ARNP
• Linda S. Stern, PHD
• Rebecca Stern, MD
• Ronald Stern, PHARM.D.
• Scott Stern
• Steven Stern, M.D.

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, 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 Mar 22, 2016; 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.