DR. JACQUELINE RENEE ANDERSON (NPI# 1316281603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316281603 |
| Entity Type | Individual |
| Full Name | DR. JACQUELINE RENEE ANDERSON |
| Credential | PHD, LCSW |
| Practice Address |
840 W Irving Park Rd Ste 302 Chicago IL 60613-3011 |
| Mailing Address |
7622 S Perry Ave Chicago IL 60620-1026 |
| Practice Telephone | 7736599207 |
| Practice Fax Number | 7737998824 |
| Mailing Telephone | 7734543768 |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2020-08-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
149.009333 | IL | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149009333 | IL | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1055 W Catalpa Ave, 317, Chicago, IL 606401550 | 7734543768 | 7733489011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154981900 | Jacqueline Anderson | Registered Nurse | 668 E 84th St, Brooklyn, NY 11236-3428 | 2019-06-14 |
| 1205245255 | Jacqueline Anderson | Nurse Practitioner | 2057 Northfield Dr, Santa Rosa, CA 95403-2073 | 2014-08-04 |
| 1336559756 | Jacqueline Davis Anderson | Nursing Care | 3300 N Elm St, Greensboro, NC 27405-3156 | 2014-05-07 |
| 1376970897 | Jacqueline Anderson | Physical Therapist | 13682 Mineral Springs Rd, West Fork, AR 72774-9380 | 2013-09-29 |
| 1922300391 | Jacqueline Marie Anderson | Speech-Language Pathologist | 6229 Lawnton St, Philadelphia, PA 19128-2601 | 2010-11-17 |
| 1851520407 | Jacqueline Marie Anderson | Counselor | 1011 N Lynndale Dr Ste 2d, Appleton, WI 54914-3091 | 2009-07-03 |
| 1700064664 | Jacqueline Alexandra Anderson | Psychologist | 1740 Se 18th St Ste 901, Ocala, FL 34471-5445 | 2008-02-03 |
| 1205903424 | Jacqueline Denise Anderson | Contractor | 640 Acr 3593, Palestine, TX 75803 | 2006-11-30 |
| 1447354931 | Jacqueline Connell Anderson | Social Worker | 590 Greene Ave, Brooklyn, NY 11216-1200 | 2006-09-13 |
| 1689200651 | Jacqueline Anderson | Counselor | 1485 Chain Bridge Rd Ste 300, Mc Lean, VA 22101-4501 | 2020-03-20 |
| Street Address |
840 W IRVING PARK RD STE 302 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60613-3011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356329080 | Laura L Grimes | Social Worker | 840 W Irving Park Rd Ste 302, Chicago, IL 60613-3011 | 2006-01-03 |
| 1700498904 | Blake Paxton | Counselor | 840 W Irving Park Rd Ste 302, Chicago, IL 60613-3011 | 2020-08-19 |
| 1407381064 | Inclusive Insight Psychotherapy & Consulting | Community/Behavioral Health | 840 W Irving Park Rd Ste 302, Chicago, IL 60613-3011 | 2017-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588261978 | Thorek Radiology Group Nfp | Radiology | 850 West Irving Park Road, Chicago, IL 60613 | 2020-10-08 |
| 1760034128 | Maryellen Karas Lajeunesse | Social Worker | 3930 N. Pine Grove Ave, #2403, Chicago, IL 60613 | 2019-07-15 |
| 1801366430 | Stephanie A Dykema | Psychologist | 4043 N Ravenswood Ave Suite 302, Chicago, IL 60613 | 2018-11-27 |
| 1487154191 | Alan Tsang | Counselor | 655 W Irving Park Rd Ste 203, Chicago, IL 60613 | 2018-02-19 |
| 1972015782 | Integrated Ortho, LLC. | Durable Medical Equipment & Medical Supplies | 3717 N. Ravenswood Ave, Suite 219w, Chicago, IL 60613 | 2017-11-02 |
| 1073048005 | Claire Jolly | Social Worker | 3701 N Ravenswood Ave Ste 301, Chicago, IL 60613 | 2017-04-27 |
| 1730626011 | Marc Fagan | Psychologist | 4101 N Ravenswood Ave., Chicago, IL 60613 | 2017-01-25 |
| 1205385671 | Sara Turner | Psychologist | 3855 N Greenview Ave # 2a, Chicago, IL 60613 | 2016-09-27 |
| 1962955997 | Michelle Montero | Psychologist | 925 W Dakin St Apt 405, Chicago, IL 60613 | 2016-07-26 |
| 1063883494 | Athletico, Ltd | Physical Therapist | 3922 North Sheridan Rd, Chicago, IL 60613 | 2015-10-12 |
| Find all providers in zip 60613 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336022 | Web Healing Collective Pllc | Social Worker | 6207 N Springfield Ave, Chicago, IL 60659-1015 | 2020-11-06 |
| 1881295186 | Belva Marie Dibert | Social Worker | 6330 S Ingleside Ave Apt 3, Chicago, IL 60637-5784 | 2020-11-03 |
| 1861092835 | Lauren Less | Social Worker | 111 East Pearson St, Chicago, IL 60611 | 2020-10-29 |
| 1164022422 | Brittany Lauren Gatchell | Social Worker | 7448 N Damen Ave Apt 3n, Chicago, IL 60645-2258 | 2020-10-27 |
| 1467052803 | Seri Elaine Porter | Social Worker | 4258 N Greenview Ave Apt 2d, Chicago, IL 60613-1173 | 2020-10-26 |
| 1255930707 | Emily Ehrens | Social Worker | 303 W Institute Pl Ste 300, Chicago, IL 60610-3080 | 2020-10-25 |
| 1316546955 | Yesenia Maldonado | Social Worker | 3922 N Sayre Ave, Chicago, IL 60634-2329 | 2020-10-24 |
| 1144829201 | Andrea Hohf, Mscd, Lcsw | Social Worker | 564 W Randolph St Ste 248, Chicago, IL 60661-2218 | 2020-10-20 |
| 1215536693 | Miracleworks Therapy & Consulting LLC | Social Worker | 2138 S Indiana Ave, Chicago, IL 60616-4930 | 2020-10-18 |
| 1104425552 | Fifth Star Collective, LLC | Social Worker | 2711 N Lawndale Ave Unit 2, Chicago, IL 60647-1127 | 2020-10-17 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.