Game Plan Therapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

GAME PLAN THERAPY, LLC

Practice address

2212 W Grace St
Kankakee, IL 60901-4591

Phone

(815) 662-5404

NPI assigned

Aug 16, 2023

Organization subpart

No

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

Authorized official

Name

Suzette Jacob, LCSW

Title

Owner/Social Worker

Phone

(815) 662-5404

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Suzette Gray, MSW, LCSW

  • Clinical Social Worker
  • Kankakee, IL
  • NPI 1962092981
  NPD

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

{
    "created_epoch": "1692144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692144000000",
    "number": "1013790708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 W GRACE ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609014591",
            "telephone_number": "815-662-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 W GRACE ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609014591",
            "telephone_number": "815-662-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAME PLAN THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-16",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "SUZETTE",
        "authorized_official_title_or_position": "OWNER/SOCIAL WORKER",
        "authorized_official_telephone_number": "815-662-5404",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iga Fudyma
• Aaron Fuerst, PT
• Morgan Taylor Funk, AGPCNP-BC
• Amanda Jean Gaikwad, PT
• Martha Gainer, APN-FNP
• Garden of Paryer Youth Center
• Garden of Prayer Youth Center
• Garden of Prayer Youth Center
• Garden of Prayer Youth Center Incorporated
• Agata Gebala

• Clinical Social Worker in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.