Jeannine Harris, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.017907 Issued in IL

Practice address

849 Maple Ave
Homewood, IL 60430-2066

Phone

(708) 414-0095

NPI assigned

Feb 26, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

Practice addresses (Care Compare)

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.

• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  IL

  Medicare reassignment Care Compare group NPD
• Linq Care Inc

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Naperville, IL
  • NPI 1710519335
  Medicare reassignment NPD
• Jeannine Harris Counseling Services, LLC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1366940868
  NPD Authorized official

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1861852345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 439456",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606439456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 MAPLE AVE",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302066",
            "telephone_number": "708-414-0095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9119 S Exchange Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606174225",
            "country_code": "US",
            "telephone_number": "773-768-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JEANNINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-26",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS LICENSE",
            "identifier": "149.017907",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clarreesa Hardin, PHARRM D.
• Jerne Hardy
• Nina Cherone Hardy, DPT
• Andrea Harris
• Dion Harris
• Rodney Harris
• Sierra Kristina Harris
• Aquanetta Kristine Hart
• Courtney Hatcher, MD
• Eric Havens

• Clinical Social Worker in Homewood, IL
• Providers in Homewood, 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 Nov 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.