Individual provider Active NPI

Loren Jessica Havrilla, LCSW

  • Clinical Social Worker
  • Skokie, IL
National Provider Identifier
1376095364
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
8924 Lamon Ave Apt 2
Skokie, IL 60077-1995
Phone
(312) 890-5800
NPI assigned
Oct 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

8924 Lamon Ave Apt 2
Skokie, IL 60077-1995

Mailing address

8924 Lamon Ave Apt 2
Skokie, IL 60077-1995
Phone (312) 890-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191111002276 IL Practitioner - Clinical Social Worker 3577995661 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Moon Senior Counseling of Illinois LLC Clinical CurrentSince Jun 15, 2020 Accepting new patients
Direct Access Counseling & Supportive Services, LLC Mental Health CurrentSince Nov 4, 2019 Accepting new patients
Energize Group, Inc Clinical CurrentSince Nov 15, 2019 Accepting new patients
Vitae Health Medical Illinois, PLLC Clinical CurrentSince Oct 1, 2024 Accepting new patients
Ultima Rehab-FL LLC PastSince Oct 1, 2019 Accepting new patients

Locations

390 Pondella Rd
Ste 9
North Ft Myers, FL 33903
Phone (239) 652-0260

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

5130 W Jackson Blvd
Chicago, IL 60644
Phone (773) 287-1429

1707 N Randall Rd
Ste 165
Elgin, IL 60123
Phone (847) 583-8998

7444 W Wilson Ave
Ste 108
Harwood Heights, IL 60706
Phone (847) 443-2000

10204 Bode St
Ste C
Plainfield, IL 60585
Phone (630) 844-7077

4950 Madison St
Unit 1391
Skokie, IL 60076

920 S Spring St
Springfield, IL 62704
Phone (217) 331-6433

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1376095364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8924 LAMON AVE APT 2",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771995",
            "telephone_number": "312-890-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8924 LAMON AVE APT 2",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771995",
            "telephone_number": "312-890-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVRILLA",
        "first_name": "LOREN",
        "middle_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.