Active NPI
Jenna Fahey
- Marriage & Family Therapist
- Chicago, IL
National Provider Identifier
1639623648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 208.000224
- Practice address
- 70 E Lake St
Suite 222
Chicago, IL 60601-5959 - Phone
- (312) 350-2462
- NPI assigned
- Aug 8, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 208.000224 | IL | Primary |
Addresses
Primary practice location
70 E Lake St
Suite 222
Chicago, IL 60601-5959
Mailing address
70 E Lake St
Suite 222
Chicago, IL 60601-5959
Phone (312) 350-2462
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 208.000224 | IL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470614400000",
"number": "1639623648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 E LAKE ST",
"address_2": "SUITE 222",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606015959",
"telephone_number": "312-350-2462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 E LAKE ST",
"address_2": "SUITE 222",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606015959",
"telephone_number": "312-350-2462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAHEY",
"first_name": "JENNA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-08",
"last_updated": "2016-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IL",
"license": "208.000224",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.