Jacqueline Herbstman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149013810 Issued in IL

Practice address

1770 W Berteau Ave
Suite 302a
Chicago, IL 60613-1849

Phone

(312) 307-9887

NPI assigned

Dec 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1588725873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3133 N LAKEWOOD AVE",
            "address_2": "APT. 4F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606579459",
            "telephone_number": "312-307-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 W BERTEAU AVE",
            "address_2": "SUITE 302A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131849",
            "telephone_number": "312-307-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBSTMAN",
        "first_name": "JACQUELINE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "212431",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149013810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sylvia Herbozo, PH.D.
• Jaime Sidell Herbst
• Leyla Rose Herbst
• Meredith Herbst
• Paula Herbst
• Elizabeth Hercher
• James J. Herdegen, MD
• Kristen Herdegen
• Here Now Counseling Services, PLLC
• Araceli Heredia, CRC, LCPC

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; 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.