Active NPI
Jamie Susan Humphreys, MSW, LCSW
- Clinical Social Worker
- Frankfort, IL
National Provider Identifier
1659928596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149021322
- Practice address
- 20635 Abbey Woods CT N Ste 309
Frankfort, IL 60423-3217 - Phone
- (815) 464-8210
- NPI assigned
- Aug 26, 2019
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149021322 | IL | Primary |
Addresses
Primary practice location
20635 Abbey Woods CT N Ste 309
Frankfort, IL 60423-3217
Mailing address
2785 E 2625TH Rd
Marseilles, IL 61341-9485
Phone (815) 560-7132
Other practice location 1
1100 E Norris Dr
Ottawa, IL 61350-1604
Phone (815) 433-3100
Other practice location 2
2785 E 2625th Rd
Marseilles, IL 61341
Phone (815) 560-7132
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
| License | State | Type | Specialty |
|---|---|---|---|
| 149021322 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clear Minds Counseling LLC | Clinical | Current | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1659928596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2785 E 2625TH RD",
"city": "MARSEILLES",
"state": "IL",
"postal_code": "613419485",
"telephone_number": "815-560-7132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20635 ABBEY WOODS CT N STE 309",
"city": "FRANKFORT",
"state": "IL",
"postal_code": "604233217",
"telephone_number": "815-464-8210"
}
],
"practiceLocations": [
{
"address_1": "1100 E Norris Dr",
"address_purpose": "LOCATION",
"city": "Ottawa",
"state": "IL",
"postal_code": "613501604",
"country_code": "US",
"telephone_number": "815-433-3100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2785 E 2625th Rd",
"address_purpose": "LOCATION",
"city": "Marseilles",
"state": "IL",
"postal_code": "61341",
"country_code": "US",
"telephone_number": "815-560-7132",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HUMPHREYS",
"first_name": "JAMIE",
"middle_name": "SUSAN",
"credential": "MSW, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-26",
"last_updated": "2020-11-17",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149021322",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Frankfort, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.