Individual provider Active NPI

Jennifer Lynn Loughran, LCSW

  • Clinical Social Worker
  • Naperville, IL
National Provider Identifier
1588905129
Registry record updated Feb 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.015593 Issued in IL
Practice address
800 W 5TH Ave
Suite 205I
Naperville, IL 60563-8965
Phone
(630) 779-0751
NPI assigned
Mar 6, 2013
Last updated
Feb 28, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2017

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 149.015593 IL Primary

Addresses

Primary practice location

800 W 5TH Ave
Suite 205I
Naperville, IL 60563-8965

Mailing address

1401 Lakewood Dr
Ste a
Morris, IL 60450-3352
Phone (630) 779-0751

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
I20140819002860 IL Practitioner - Clinical Social Worker 9931327731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mending Hearts TherapyGroup PAC ID 5597131318, 2 clinicians

Practice addresses (Care Compare)

815 S Laura LN
Diamond, IL 60416-9314
Phone (630) 309-0926

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.015593ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mending Hearts Therapy CurrentSince Aug 31, 2022 Accepting new patients
Human Services Consulting Group Inc Clinical PastSince Feb 16, 2019 Accepting new patients
Dupage Medical Group LTD PastSince Feb 28, 2017 Accepting new patients

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, 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": "1362528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488240000000",
    "number": "1588905129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 LAKEWOOD DR",
            "address_2": "STE A",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604503352",
            "telephone_number": "630-779-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W 5TH AVE",
            "address_2": "SUITE 205I",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638965",
            "telephone_number": "630-779-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUGHRAN",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-06",
        "last_updated": "2017-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.015593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.