Individual provider Active NPI

Jennifer N Lila, LCSW, CSAC

  • Clinical Social Worker
  • Sussex, WI
National Provider Identifier
1710419247
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9100-123 Issued in WI
Practice address
N64W24050 Main St Ste 207
Sussex, WI 53089-3000
Phone
(262) 501-6533
NPI assigned
Apr 3, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 16400-132 WI
Clinical Social Worker 1041C0700X 9100-123 WI Primary

Addresses

Primary practice location

N64W24050 Main St Ste 207
Sussex, WI 53089-3000

Mailing address

W245N6630 Bowling Green St
Sussex, WI 53089-2638
Phone (262) 501-6533

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16400-132WIMDAddiction (Substance Use Disorder) Counselor
9100-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer Lila Clinical CurrentSince Aug 11, 2024 Accepting new patients
Oakwood Clinical Associates, LTD Addiction (Substance Use Disorder) PastSince Mar 12, 2015 Accepting new patients

Locations

N64W24050 Main St
Ste 207
Sussex, WI 53089
Phone (262) 501-6533

Organizations & group practices 2

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": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1710419247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W245N6630 BOWLING GREEN ST",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "530892638",
            "telephone_number": "262-501-6533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N64W24050 MAIN ST STE 207",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "530893000",
            "telephone_number": "262-501-6533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILA",
        "first_name": "JENNIFER",
        "middle_name": "N",
        "credential": "LCSW,  CSAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16400-132",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9100-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sussex, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.