Individual provider Active NPI

Jamie Floersch, LCSW

  • Clinical Social Worker
  • Lincolnwood, IL
National Provider Identifier
1548677537
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.016833 Issued in IL
Practice address
4433 W Touhy Ave
Suite 403
Lincolnwood, IL 60712-1820
Phone
(847) 834-9739
NPI assigned
Jul 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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 149.016833 IL Primary

Addresses

Primary practice location

4433 W Touhy Ave
Suite 403
Lincolnwood, IL 60712-1820

Mailing address

4433 W Touhy Ave
Suite 403
Lincolnwood, IL 60712-1820
Phone (847) 834-9739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: No
  • 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
I20140908002510 IL Practitioner - Clinical Social Worker 1850510785 Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2650 W Montrose Ave
Chicago, IL 60618-1560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.016833ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Britt Borden CurrentSince Aug 11, 2019 Accepting new patients
The Juniper Center PC PastSince May 29, 2010 Accepting new patients
Unfettered Psychotherapy & Consulting LLC Clinical PastSince May 19, 2024 Accepting new patients

Locations

906 Davis St
Evanston, IL 60201
Phone (847) 492-1778

Organizations & group practices 3

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": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1548677537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4433 W TOUHY AVE",
            "address_2": "SUITE 403",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121820",
            "telephone_number": "847-834-9739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4433 W TOUHY AVE",
            "address_2": "SUITE 403",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121820",
            "telephone_number": "847-834-9739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOERSCH",
        "first_name": "JAMIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.016833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincolnwood, IL

Sources for this page

Verify at the official NPI Registry.