Provider Demographics
NPI:1942191499
Name:BOSWORTH, JENNIFER (LPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BOSWORTH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JEN
Other - Middle Name:
Other - Last Name:BOSWORTH-RAMIREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:835 RIDGE AVE APT 303
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-1729
Mailing Address - Country:US
Mailing Address - Phone:224-578-3692
Mailing Address - Fax:
Practice Address - Street 1:835 RIDGE AVE APT 303
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-1729
Practice Address - Country:US
Practice Address - Phone:224-578-3692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional