Individual provider Active NPI

Jamie Lynn Hayden, L.C.S.W.

  • Clinical Social Worker
  • Oak Park, IL
National Provider Identifier
1710311550
Registry record updated Dec 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.015068 Issued in IL
Practice address
1016 S Maple Ave
Oak Park, IL 60304-1805
Phone
(847) 414-7089
NPI assigned
Aug 28, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2016

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 149.015068 IL Primary

Addresses

Primary practice location

1016 S Maple Ave
Oak Park, IL 60304-1805

Mailing address

1016 S Maple Ave
Oak Park, IL 60304-1805
Phone (847) 414-7089

Other identifiers 1

IdentifierTypeStateIssuer
IL6398OtherILMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • 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
I20131031001497 IL Practitioner - Clinical Social Worker 4789819616 Practice locations: Forest Park, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1525 Circle Ave
Suite 2
Forest Park, IL 60130-2647
Phone (708) 406-9451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.015068ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481414400000",
    "number": "1710311550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 S MAPLE AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041805",
            "telephone_number": "847-414-7089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 S MAPLE AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041805",
            "telephone_number": "847-414-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYDEN",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-28",
        "last_updated": "2016-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.015068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "IL6398",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.