Amy Marie Jakubiak, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.015364 Issued in IL

Practice address

72 S la Grange Rd Ste 12
La Grange, IL 60525-6317

Phone

(773) 507-3631

NPI assigned

May 1, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Amy Marie Uscila Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• With Wings Therapy Group, PLLC

  • Clinical Social Worker
  • La Grange, IL
  • NPI 1619641560
  NPD Authorized official

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

{
    "created_epoch": "1398902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1851701726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 S LA GRANGE RD STE 12",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605256317",
            "telephone_number": "773-507-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 S LA GRANGE RD STE 12",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605256317",
            "telephone_number": "773-507-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAKUBIAK",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-01",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.015364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "USCILA",
            "middle_name": "MARIE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Integrative Family Health Associates
• Rachel Ivanovic, BCBA, LBA
• Agnieszka Iwaszczyszyn, DMD
• Arun Jacob, MD
• Jaime K Lewis, LLC
• Devon Marie James, D.C.
• Tabatha N James
• Patricia Janowski, RD
• Annamarie Ciancio Jansky, DDS
• Ryan Jarta

• Clinical Social Worker in La Grange, IL
• Providers in La Grange, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; 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.