Organization Active NPI

James Simmerer, LCSW, Counseling & Psychotherapy Services, LLC

  • Clinical Social Worker
  • Orland Park, IL
National Provider Identifier
1851442628
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
JAMES SIMMERER, LCSW, COUNSELING & PSYCHOTHERAPY SERVICES, LLC
Practice address
11309 Distinctive Dr
Orland Park, IL 60467-9460
Phone
(708) 228-0475
Fax
(708) 326-4095
NPI assigned
Jan 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
James Paul Simmerer, M.S.W., L.C.S.W.NPI 1790982908
Title
Therapist
Phone
(708) 228-0475

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X IL Primary

Addresses

Primary practice location

11309 Distinctive Dr
Orland Park, IL 60467-9460

Mailing address

22W267 First St.
Glen Ellyn, IL 60137-3530
Phone (708) 228-0475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040706000943 IL Part B Supplier - Clinic/Group Practice 8921085119 Receives reassigned benefits from 1 practitioner
Practice locations: Glen Ellyn, IL; Orland Park, IL; Flossmoor, IL

National Provider Directory

National Provider Directory

Locations

4747 Lincoln Mall Dr
Ste 410
Matteson, IL 60443
Phone (630) 499-6197

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851442628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22W267 FIRST ST.",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601373530",
            "telephone_number": "708-228-0475",
            "fax_number": "708-326-4095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11309 DISTINCTIVE DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604679460",
            "telephone_number": "708-228-0475",
            "fax_number": "708-326-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES SIMMERER, LCSW, COUNSELING & PSYCHOTHERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIMMERER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "708-228-0475",
        "authorized_official_credential": "M.S.W., L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.