Provider Demographics
NPI:1962858209
Name:LEVINSON, JENNA N (LCSW)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:N
Last Name:LEVINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:676 N SAINT CLAIR ST STE 1000
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2976
Mailing Address - Country:US
Mailing Address - Phone:312-695-5060
Mailing Address - Fax:312-695-5507
Practice Address - Street 1:676 N SAINT CLAIR ST STE 1000
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2976
Practice Address - Country:US
Practice Address - Phone:312-695-5060
Practice Address - Fax:312-695-5507
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490184341041C0700X
CA1044071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1962858209Medicaid