Individual provider Active NPI

Jane Skirven, LCSW

  • Clinical Social Worker
  • McHenry, IL
National Provider Identifier
1629179098
Registry record updated Nov 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.013873 Issued in IL
Practice address
4100 Veterans Pkwy
McHenry, IL 60050-8350
Phone
(815) 669-2456
NPI assigned
Sep 26, 2006
Last updated
Nov 5, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC5638
Clinical Social Worker 1041C0700X 149.013873 IL Primary

Addresses

Primary practice location

4100 Veterans Pkwy
McHenry, IL 60050-8350

Mailing address

2351 Partridge Woods CT
Burlington, WI 53105-6901
Phone (262) 763-1922

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.013873ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Acadia Healthcare, Inc Past Accepting new patients

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, 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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288915200000",
    "number": "1629179098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2351 PARTRIDGE WOODS CT",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531056901",
            "telephone_number": "262-763-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 VETERANS PKWY",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508350",
            "telephone_number": "815-669-2456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKIRVEN",
        "first_name": "JANE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2010-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "LC5638",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.013873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; 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.