Gabriel Jara-Almonte Edwards, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.022221 Issued in IL

Practice address

1440 Renaissance Dr Ste 320
Park Ridge, IL 60068-1471

Phone

(847) 759-9110

Fax

(847) 759-9440

NPI assigned

Jul 9, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• The Juniper Center PC

  • Mental Health Counselor
  • Park Ridge, IL
  • NPI 1902906324
  NPD

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1023689015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 W BIRCHWOOD AVE APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606452172",
            "telephone_number": "312-884-9746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 RENAISSANCE DR STE 320",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681471",
            "telephone_number": "847-759-9110",
            "fax_number": "847-759-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "GABRIEL",
        "middle_name": "JARA-ALMONTE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-09",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.022221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edison DME LTD
• Kathleen Edmier, PSYD, BCBA
• Edward Hines VA Hospital
• Alicia R Edwards, RD
• Carolyn Vale Edwards, PH.D.
• Janis L Edwards, L.C.S.W.
• Paul Edwards, PMHNP
• Jayne Chinwoke Ehirim, DNP, APRN, PMHNP-BC
• Karen J. Eklind, L.C.S.W.
• Chawki F El Zein, MD

• Clinical Social Worker in Park Ridge, IL
• Providers in Park Ridge, 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 Jul 9, 2021; 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.