Jessica Lynne Anderson-Gonzalez, LCSW
Individual provider Active NPI Clinical Social Worker · Joliet, IL
NPI 1053788331 · NPPES record last updated Jan 9, 2023
Key facts
- NPI
- 1053788331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 149.017715 (IL)
- Practice address
- 350 Houbolt Rd
Joliet, IL 60431-8305 - Phone
- (779) 379-2654
- NPI assigned
- Aug 21, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.017715 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Illinois Neurotherapy Associates | Clinical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.017715 | IL | Yes |
Addresses
Primary practice location
350 Houbolt Rd
Joliet, IL 60431-8305
Mailing address
25800 S Basswood Rd
Channahon, IL 60410-3397
Phone (779) 379-2654
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | unknown |
Other providers in Joliet, IL
- Amt Counseling Management Services
- Amt Counseling Mnagement Servises
- Amy Ray, PH.D., P.C.
- Anand Wellness Corp
- Anchor & Thrive Clinical Social Work Services, LLC
- Grace Caroline Anderson
- Julie A Anderson
- Kelsey Malia Anderson
- Andersontiernan, Inc
- Quennie Hannah Andrada
All providers in Joliet, IL · Clinical Social Worker in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.