NPIMap

Organization Active NPI

Summit Counseling Group Professional Corporation

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1649833575
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SUMMIT COUNSELING GROUP PROFESSIONAL CORPORATION
Practice address
3047 N Lincoln Ave Unit 400
Chicago, IL 60657-4274
Phone
(609) 947-3879
Fax
(773) 404-5837
NPI assigned
Apr 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

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

Authorized official

Name
Jane Elizabeth Shersher, LCSW
Title
Executive Director
Phone
(609) 947-3879

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

3047 N Lincoln Ave Unit 400
Chicago, IL 60657-4274

Mailing address

3047 N Lincoln Ave Unit 400
Chicago, IL 60657-4274
Phone (609) 947-3879

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555372800000",
    "number": "1649833575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3047 N LINCOLN AVE UNIT 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574274",
            "telephone_number": "609-947-3879",
            "fax_number": "773-404-5837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3047 N LINCOLN AVE UNIT 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574274",
            "telephone_number": "609-947-3879",
            "fax_number": "773-404-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT COUNSELING GROUP PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-16",
        "last_updated": "2019-04-16",
        "status": "A",
        "authorized_official_last_name": "SHERSHER",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "609-947-3879",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "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 16, 2019; 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.