Jenny K Philipson, LCSW

Primary specialty

CounselorTaxonomy code 101Y00000X

License

149009140 Issued in IL

Practice address

636 Church St Suite 601
Evanston, IL 60201

Phone

(847) 644-2462

Fax

(847) 328-3703

NPI assigned

Jul 7, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Jenny P Lewis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Clinician'S Incubator LLC

  dba Nutrition Hive

  • Nutritionist
  • Skokie, IL
  • NPI 1083232474
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1720010622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 SHERIDAN ROAD 1 W",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "60202",
            "telephone_number": "847-644-2462",
            "fax_number": "847-328-3703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 CHURCH ST SUITE 601",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "60201",
            "telephone_number": "847-644-2462",
            "fax_number": "847-328-3703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIPSON",
        "first_name": "JENNY",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149009140",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "149009140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNY",
            "last_name": "LEWIS",
            "middle_name": "P",
            "prefix": "MISS",
            "credential": "M.A., L.C.S.W.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ngan Tran Khanh Pham, MD
• Van D Pham, O.D.
• Philip H Sheridan Jr SC
• KJ Philip, MD
• Jessica Philipp, CCC-SLP
• Daniel K. Phillip, PSY.D.
• Amarii Phillips
• Benjamin Phillips
• Elliot Phillips, MA
• Isaac S Phillips

• Counselor in Evanston, IL
• Providers in Evanston, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.