Individual provider Active NPI

Jonah Stevenson

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1962048934
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.027137 Issued in IL
Practice address
155 N Michigan Ave Ste 450
Chicago, IL 60601-7939
Phone
(317) 603-7753
NPI assigned
Nov 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.027137 IL Primary

Addresses

Primary practice location

155 N Michigan Ave Ste 450
Chicago, IL 60601-7939

Mailing address

155 N Michigan Ave Ste 450
Chicago, IL 60601-7939
Phone (872) 395-8091

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
I20240626004466 IL Practitioner - Clinical Social Worker 2365986700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cira Center for Behavioral Health PCGroup PAC ID 3870879190, 5 clinicians

Practice addresses (Care Compare)

1011 Lake St
Suite 307
Oak Park, IL 60301-1138
Phone (872) 395-8091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.027137ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cira Center for Behavioral Health PC CurrentSince May 15, 2024 Accepting new patients

Locations

155 N Michigan Ave
Ste 450
Chicago, IL 60601
Phone (872) 395-8091

1011 Lake St
Ste 307
Oak Park, IL 60301
Phone (872) 395-8091

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1962048934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 N MICHIGAN AVE STE 450",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017939",
            "telephone_number": "872-395-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N MICHIGAN AVE STE 450",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017939",
            "telephone_number": "317-603-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "JONAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-25",
        "last_updated": "2024-05-06",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.027137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.