Provider Demographics
NPI:1427368216
Name:JENNINGS, BEVERLY (LCSW)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BEVERLY
Other - Middle Name:
Other - Last Name:LINDSAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2045 W GRAND AVE STE B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-1577
Mailing Address - Country:US
Mailing Address - Phone:888-660-4425
Mailing Address - Fax:
Practice Address - Street 1:873 GROVE ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:IL
Practice Address - Zip Code:62650-2828
Practice Address - Country:US
Practice Address - Phone:217-479-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490298361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical