Provider Demographics
NPI:1336622752
Name:MACIAS, JENNIFER (LMFT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MACIAS
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 W MONTROSE AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-1562
Mailing Address - Country:US
Mailing Address - Phone:773-377-5261
Mailing Address - Fax:872-813-4596
Practice Address - Street 1:2650 W MONTROSE AVE STE 102
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-1562
Practice Address - Country:US
Practice Address - Phone:773-377-5261
Practice Address - Fax:872-813-4596
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist