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1972058295 NPI number — JENNIFER LEE BONINO SOBOL PH.D., LCPC

NPI Number: 1972058295
Health Care Provider/Practitioner: JENNIFER LEE BONINO SOBOL PH.D., LCPC

Information about “1972058295” NPI (JENNIFER LEE BONINO SOBOL PH.D., LCPC) exists in 1972058295 in HTML format HTML  |  1972058295 in plain Text format TXT  |  1972058295 in PDF (Portable Document Format) PDF  |  1972058295 in an XML format XML  formats.

NPI Number : 1972058295 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1972058295",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BONINO SOBOL",
    "FirstName": "JENNIFER",
    "MiddleName": "LEE",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PH.D., LCPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BONINO",
    "OtherFirstName": "JENNIFER",
    "OtherMiddleName": "LEE",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "PH.D., LCPC",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1120 WICKHAM CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NAPERVILLE",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60540-8319",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "312-583-7171",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "17 N DEARBORN ST FL 15",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHICAGO",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60602-4310",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "312-583-7171",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/16/2016",
    "LastUpdateDate": "06/24/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "LPC-MH30730",
          "LicenseNumberStateCode": "SD",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "39004877A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "180.011558",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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