Individual provider Active NPI

Jodie Erin Singer, M.A., PSY.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1720394356
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.007920 Issued in IL
Practice address
25 E Washington St Ste 1717
Chicago, IL 60602-1839
Phone
(312) 566-8536
NPI assigned
Aug 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.007920 IL Primary

Addresses

Primary practice location

25 E Washington St Ste 1717
Chicago, IL 60602-1839

Mailing address

5246 W Carmen Ave
Chicago, IL 60630-2211
Phone (312) 566-8536

Other identifiers 1

IdentifierTypeStateIssuer
1720394356OtherILPERSONAL NPI

Other names 1

  • Jodie Erin Goldberg Professional name

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
I20170203001748 IL Practitioner - Clinical Psychologist 2062795719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chicago Center for Growth and Change, LLCGroup PAC ID 3678856598, 2 clinicians

Practice addresses (Care Compare)

25 E Washington St
Suite 1717
Chicago, IL 60602-1839
Phone (312) 566-8536

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
071.007920ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Center for Growth and Change Concierge Therapy, LLC Clinical Current Accepting new patients
Chicago Center for Growth and Change, LLC Clinical CurrentSince Jan 1, 2017 Accepting new patients

Locations

150 N Michigan Ave
Ste 800
Chicago, IL 60601
Phone (312) 566-8536

25 E Washington St
Ste 1717
Chicago, IL 60602
Phone (312) 566-8536

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": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1720394356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5246 W CARMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302211",
            "telephone_number": "312-566-8536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E WASHINGTON ST STE 1717",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021839",
            "telephone_number": "312-566-8536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINGER",
        "first_name": "JODIE",
        "middle_name": "ERIN",
        "name_prefix": "Dr.",
        "credential": "M.A., PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-20",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.007920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1720394356",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODIE",
            "last_name": "GOLDBERG",
            "middle_name": "ERIN",
            "credential": "M.A., PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.