Individual provider Active NPI

Amanda Jones, LSW, JD

  • Social Worker
  • Evanston, IL
National Provider Identifier
1558791285
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150.014573 Issued in IL
Practice address
1840 Oak Ave
Evanston, IL 60201-3642
Phone
(847) 512-4425
NPI assigned
Nov 15, 2013
Last updated
Nov 15, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.014573 IL Primary

Addresses

Primary practice location

1840 Oak Ave
Evanston, IL 60201-3642

Mailing address

2131 W Giddings St
Apt. 3a
Chicago, IL 60625-1494
Phone (920) 988-7549

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
Credentials
Juris Doctor

State licenses

LicenseStateTypeSpecialty
150.014573ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nurtured Roots Counseling and Consulting, LLC Current Accepting new patients
Connected Counseling Chicago, LLC Past Accepting new patients

Locations

4327 W Irving Park Rd
Ste 2A
Chicago, IL 60641
Phone (224) 458-5027

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384473600000",
    "number": "1558791285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 W GIDDINGS ST",
            "address_2": "APT. 3A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606251494",
            "telephone_number": "920-988-7549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 OAK AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013642",
            "telephone_number": "847-512-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "AMANDA",
        "credential": "LSW, JD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-15",
        "last_updated": "2013-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.014573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; 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.