Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jaq L Zuidema, LCSW, ASDCS, TIYT

Individual provider Mental Health Counselor · NPI 1043749310

Jaq L Zuidema, LCSW, ASDCS, TIYT is a Mental Health Counselor in Chicago, Illinois. Practices as a sole proprietor. Licensed in Illinois and Oklahoma.

Licensed in
IL, OK
In the registry since
2017
Specialties on file
4
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

4000 W Montrose Ave # 790
Chicago, IL 60641-2140
Phone: (918) 558-0338
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 149.028001 (IL)
Mental Health Counselor Taxonomy 101YM0800X
Clinical Social Worker Taxonomy 1041C0700X · Licence 21219 (OK)
Case Manager/Care Coordinator Taxonomy 171M00000X

Record details

NPI number1043749310
Entity typeIndividual (Type 1)
GenderNot disclosed
Credentials LCSW , ASDCS , TIYT
Sole proprietorYes
NPI enumeratedJune 8, 2017
Last updated in NPPESMay 14, 2025
Certification dateMay 14, 2025

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