Individual provider Active NPI

Jennifer Solomon, LMFT

  • Marriage & Family Therapist
  • Northbrook, IL
National Provider Identifier
1962197038
Registry record updated Jul 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
166.001765 Issued in IL
Practice address
910 Skokie Blvd Ste 106
Northbrook, IL 60062-4032
Phone
(773) 425-4201
NPI assigned
Apr 5, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 166.001765 IL Primary

Addresses

Primary practice location

910 Skokie Blvd Ste 106
Northbrook, IL 60062-4032

Mailing address

1155 Melvin Dr
Highland Park, IL 60035-4510
Phone (773) 425-4201

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
I20241017003063 IL Practitioner - Marriage and Family Therapist 7517499395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affiliates in Counseling LLCGroup PAC ID 1254478514, 12 clinicians

Practice addresses (Care Compare)

910 Skokie Blvd
Suite 215
Northbrook, IL 60062-4033
Phone (847) 480-0300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
166.001765ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliates in Counseling LLC Marriage & Family Therapist CurrentSince Oct 9, 2024 Accepting new patients

Locations

910 Skokie Blvd
Ste 103
Northbrook, IL 60062
Phone (773) 551-2811

910 Skokie Blvd
Ste 215
Northbrook, IL 60062
Phone (847) 412-0280

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": "1680652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720310400000",
    "number": "1962197038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 MELVIN DR",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600354510",
            "telephone_number": "773-425-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 SKOKIE BLVD STE 106",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624032",
            "telephone_number": "773-425-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "JENNIFER",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-05",
        "last_updated": "2024-07-07",
        "certification_date": "2024-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.001765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.