Active NPI
Cynthia Jones, CADC
- Addiction (Substance Use Disorder) Counselor
- Chicago, IL
National Provider Identifier
1457630378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 22764
- Practice address
- 4740 N Clark St
Chicago, IL 60640-4689 - Phone
- (773) 769-0205
- Fax
- (773) 765-0794
- NPI assigned
- Aug 9, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 22764 | IL | Primary |
Addresses
Primary practice location
4740 N Clark St
Chicago, IL 60640-4689
Mailing address
4740 N Clark St
Chicago, IL 60640-4689
Phone (773) 769-0205
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1616824 | Other | IL | BLUE SHIELD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22764 | IL | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312848000000",
"number": "1457630378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4740 N CLARK ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606404689",
"telephone_number": "773-769-0205",
"fax_number": "773-765-0794"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4740 N CLARK ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606404689",
"telephone_number": "773-769-0205",
"fax_number": "773-765-0794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "CYNTHIA",
"credential": "CADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-09",
"last_updated": "2011-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IL",
"license": "22764",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "1616824",
"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 Aug 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.