Individual provider Active NPI

Julie Ann Logan, LCSW

  • Clinical Social Worker
  • Cherry Valley, IL
National Provider Identifier
1700058005
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149011421 Issued in IL
Practice address
1740 S Bell School Rd Ste B
Cherry Valley, IL 61016-9388
Phone
(815) 316-2621
Fax
(800) 493-9260
NPI assigned
Mar 26, 2008
Last updated
Jul 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149011421 IL Primary

Addresses

Primary practice location

1740 S Bell School Rd Ste B
Cherry Valley, IL 61016-9388

Mailing address

1740 S Bell School Rd Ste B
Cherry Valley, IL 61016-9388
Phone (815) 316-2621

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlogan@loganhh.com Direct Logan Health & Healing Center, Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051213000471 IL Practitioner - Clinical Social Worker 3577584937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149011421ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Julie Logan Counseling, Inc Clinical CurrentSince Oct 16, 2022 Accepting new patients
Logan Counseling Inc. Clinical Past Accepting new patients

Locations

1740 S Bell School Rd
Ste B
Cherry Valley, IL 61016
Phone (815) 316-2621

Interoperability endpoints

  • Direct secure messaging: jlogan@loganhh.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1700058005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 S BELL SCHOOL RD STE B",
            "city": "CHERRY VALLEY",
            "state": "IL",
            "postal_code": "610169388",
            "telephone_number": "815-316-2621",
            "fax_number": "800-493-9260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 S BELL SCHOOL RD STE B",
            "city": "CHERRY VALLEY",
            "state": "IL",
            "postal_code": "610169388",
            "telephone_number": "815-316-2621",
            "fax_number": "800-493-9260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-26",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149011421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlogan@loganhh.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Logan Health & Healing Center, Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1740 S Bell School Rd Ste B",
            "city": "Cherry Valley",
            "state": "IL",
            "country_code": "US",
            "postal_code": "610169388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cherry Valley, IL

Sources for this page

Verify at the official NPI Registry.