Richara Jennings, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071-007563 Issued in IL

Practice address

10343 S Western Ave
Chicago, IL 60643-2410

Phone

(773) 238-2828

Fax

(708) 974-3845

NPI assigned

Nov 15, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Visions for Change Counseling Center, PC

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1336357003
  NPD (past) Authorized official
• Psychology Center P.C.

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1396735361
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1669545208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9449 S KEDZIE AVE",
            "address_2": "STE 306",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052325",
            "telephone_number": "773-510-0104",
            "fax_number": "708-620-8631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10343 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606432410",
            "telephone_number": "773-238-2828",
            "fax_number": "708-974-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "RICHARA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-007563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDFPR",
            "identifier": "071-007563",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS  MEDICARE PTAN",
            "identifier": "IL1583002",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lawrence John Jennings, M.D., PH.D.
• Mary T Jennings, PSYD
• Michelle Jennings
• Moira Jennings, M.S., CCC-SLP
• Patrick Joseph Jennings, MD
• Stephen Nathaniel Jennings, M.A.
• Steven L Jennings Jr., M.A.
• Tyrone Jennings
• Jenns Heart and Hands LLC
• Jenny Choi LCSW LLC

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; 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.