Individual provider Active NPI

Jennifer Lynn Bean, LCSW

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1972730802
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.013625 Issued in IL
Practice address
2334 W Lawrence Ave
Suite 204
Chicago, IL 60625-1948
Phone
(773) 908-4375
Fax
(773) 878-1701
NPI assigned
Jun 18, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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 149.013625 IL Primary

Addresses

Primary practice location

2334 W Lawrence Ave
Suite 204
Chicago, IL 60625-1948

Mailing address

2334 W Lawrence Ave
Suite 204
Chicago, IL 60625-1948
Phone (773) 908-4375

Other identifiers 1

IdentifierTypeStateIssuer
149.013625OtherILBLUE SHIELD

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
I20090710000231 IL Practitioner - Clinical Social Worker 8224180963 Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2234 W Lawrence Ave
Suite 204
Chicago, IL 60625-1045

2334 W Lawrence Ave
Chicago, IL 60625-1045
Phone (773) 908-4386

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.013625ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1972730802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2334 W LAWRENCE AVE",
            "address_2": "SUITE 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606251948",
            "telephone_number": "773-908-4375",
            "fax_number": "773-878-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2334 W LAWRENCE AVE",
            "address_2": "SUITE 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606251948",
            "telephone_number": "773-908-4375",
            "fax_number": "773-878-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAN",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.013625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "149.013625",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.