Individual provider Active NPI

Laura E Kowalski, LCPC

  • Professional Counselor
  • Saint Charles, IL
National Provider Identifier
1003242603
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180008166 Issued in IL
Practice address
1121 E Main St Ste 405
Saint Charles, IL 60174-2296
Phone
(630) 344-9623
Fax
(331) 422-3230
NPI assigned
Sep 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 180 008166 IL
Professional Counselor 101YP2500X 180008166 IL Primary

Addresses

Primary practice location

1121 E Main St Ste 405
Saint Charles, IL 60174-2296

Mailing address

1121 E Main St Ste 405
Saint Charles, IL 60174-2296
Phone (630) 344-9623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 18, 2024 through Jan 18, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
180008166ILMDProfessional Counselor
180 008166ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Growing Through Life Therapy LLC Professional Current Accepting new patients

Locations

1121 E Main St
Ste 405
St Charles, IL 60174
Phone (331) 222-7915

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1003242603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 E MAIN ST STE 405",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601742296",
            "telephone_number": "630-344-9623",
            "fax_number": "331-422-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 E MAIN ST STE 405",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601742296",
            "telephone_number": "630-344-9623",
            "fax_number": "331-422-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKI",
        "first_name": "LAURA",
        "middle_name": "E",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-16",
        "last_updated": "2021-12-06",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "180 008166",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180008166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, IL

Sources for this page

Verify at the official NPI Registry.