Individual provider Active NPI

Jasmine Studway, LCSW

  • Clinical Social Worker
  • Flossmoor, IL
National Provider Identifier
1730663089
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149020815
Practice address
19624 Governors Hwy Ste 2
Flossmoor, IL 60422-2086
Phone
(218) 389-1095
NPI assigned
Sep 22, 2018
Last updated
Feb 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149020815 IL
Clinical Social Worker 1041C0700X 149020815 Primary

Addresses

Primary practice location

19624 Governors Hwy Ste 2
Flossmoor, IL 60422-2086

Mailing address

19624 Governors Hwy Ste 2
Flossmoor, IL 60422-2086
Phone (708) 746-5454

Other names 1

  • Jasmine Studway LCSW LLC 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
I20230620001016 IL Practitioner - Clinical Social Worker 0244698579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19624 Governors Hwy
Suite 101
Flossmoor, IL 60422-2077
Phone (779) 242-0850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
S.I.S & Associates, LLC Clinical CurrentSince May 23, 2023 Accepting new patients

Locations

19624 Governors Hwy
Ste 101
Flossmoor, IL 60422
Phone (708) 746-5454

19624 Governors Hwy
Ste 2
Flossmoor, IL 60422
Phone (218) 389-1095

Organizations & group practices 1

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": "1537574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1730663089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19624 GOVERNORS HWY STE 2",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604222086",
            "telephone_number": "708-746-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19624 GOVERNORS HWY STE 2",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604222086",
            "telephone_number": "218-389-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUDWAY",
        "first_name": "JASMINE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-22",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149020815",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "149020815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JASMINE",
            "last_name": "STUDWAY LCSW LLC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Flossmoor, IL

Sources for this page

Verify at the official NPI Registry.