The Center for Jewish Adolescent Therapy

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149015020 Issued in IL

Legal business name

THE CENTER FOR JEWISH ADOLESCENT THERAPY

Practice address

3557 W Peterson Ave
Suite 128
Chicago, IL 60659-3218

Phone

(917) 541-2740

NPI assigned

Mar 8, 2016

Organization subpart

No

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

Authorized official

Name

Lori J Newman, BA CPC

Title

Administrator

Phone

(708) 560-6653

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457395200000",
    "number": "1326409111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3557 W PETERSON AVE",
            "address_2": "SUITE 128",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3557 W PETERSON AVE",
            "address_2": "SUITE 128",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593218",
            "telephone_number": "917-541-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CENTER FOR JEWISH ADOLESCENT THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-08",
        "last_updated": "2016-03-08",
        "status": "A",
        "authorized_official_last_name": "NEWMAN",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "708-560-6653",
        "authorized_official_credential": "BA CPC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 8, 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.