Individual provider Active NPI

Jennifer Lyn Thomas, MA, LCPC, LASOP

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1275209785
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.017130 Issued in IL
Practice address
1200 W 35TH St Ste 346
Chicago, IL 60609-1305
Phone
(773) 633-4841
NPI assigned
Aug 17, 2021
Last updated
Sep 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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 178.017130 IL Primary

Addresses

Primary practice location

1200 W 35TH St Ste 346
Chicago, IL 60609-1305

Mailing address

1200 W 35TH St Ste 346
Chicago, IL 60609-1305
Phone (773) 633-4841

Other identifiers 1

IdentifierTypeStateIssuer
178.017130OtherILLPC

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
178.017130ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer Lyn Thomas Professional CurrentSince Oct 2, 2022 Accepting new patients

Locations

1200 W 35th St
Ste 346
Chicago, IL 60609
Phone (773) 633-4841

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1275209785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W 35TH ST STE 346",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606091305",
            "telephone_number": "773-633-4841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W 35TH ST STE 346",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606091305",
            "telephone_number": "773-633-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JENNIFER",
        "middle_name": "LYN",
        "credential": "MA, LCPC, LASOP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-17",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.017130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "178.017130",
            "state": "IL"
        }
    ],
    "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 Sep 27, 2022; 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.