Individual provider Active NPI

Jennifer Dicostanzo

  • Clinical Social Worker
  • Naperville, IL
National Provider Identifier
1487072070
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.018138 Issued in IL
Practice address
1755 Park St Ste 200
Naperville, IL 60563-8404
Phone
(331) 305-4464
Fax
(630) 381-8556
NPI assigned
Apr 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 30755 IL
Clinical Social Worker 1041C0700X 149.018138 IL Primary

Addresses

Primary practice location

1755 Park St Ste 200
Naperville, IL 60563-8404

Mailing address

1080 Serendipity Dr
Aurora, IL 60504-4737
Phone (630) 973-8583

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
I20160602000263 IL Practitioner - Clinical Social Worker 7315237435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Serendipity Counseling Services, PLLCGroup PAC ID 0648643973, 5 clinicians

Practice addresses (Care Compare)

29 W170 Butterfield Rd
Suite 101
Warrenville, IL 60555-2808
Phone (331) 305-4464

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30755ILMDAddiction (Substance Use Disorder) Counselor
149.018138ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Serendipity Counseling Services, PLLC CurrentSince Nov 1, 2022 Accepting new patients

Locations

1755 Park St
Ste 200
Naperville, IL 60563
Phone (331) 244-0169

29W170 Butterfield Rd
Ste 101
Warrenville, IL 60555
Phone (331) 305-4464

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1487072070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 SERENDIPITY DR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605044737",
            "telephone_number": "630-973-8583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 PARK ST STE 200",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638404",
            "telephone_number": "331-305-4464",
            "fax_number": "630-381-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICOSTANZO",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-01",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "30755",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.