NPIMap

Organization Active NPI

Jackie the Social Worker

  • Community/Behavioral Health Agency
  • Chicago, IL
National Provider Identifier
1639922396
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
JACKIE THE SOCIAL WORKER
Practice address
4422 N Ravenswood Ave # 1016
Chicago, IL 60640-5803
Phone
(773) 217-8662
Fax
(888) 690-5661
NPI assigned
Apr 10, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Authorized official

Name
Mrs. Jackeline Elizabeth Mitchell, LCSWNPI 1649944679
Title
Owner/Therapist
Phone
(773) 217-8662

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

4422 N Ravenswood Ave # 1016
Chicago, IL 60640-5803

Mailing address

4422 N Ravenswood Ave # 1016
Chicago, IL 60640-5803
Phone (773) 217-8662

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1712707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1639922396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 N RAVENSWOOD AVE # 1016",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405803",
            "telephone_number": "773-217-8662",
            "fax_number": "888-690-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4422 N RAVENSWOOD AVE # 1016",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405803",
            "telephone_number": "773-217-8662",
            "fax_number": "888-690-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKIE THE SOCIAL WORKER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-10",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JACKELINE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "773-217-8662",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "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 Apr 10, 2024; 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.