NPIMap

Organization Active NPI

Inner Growth Therapy Services, LLC

  • Clinical Social Worker
  • Geneva, IL
National Provider Identifier
1164980983
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
INNER GROWTH THERAPY SERVICES, LLC
Practice address
825 W State St Ste 119D
Geneva, IL 60134-2079
Phone
(630) 296-9566
NPI assigned
Mar 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Authorized official

Name
Alexandra Gonzalez-Konopacki, LCSW
Title
Owner
Phone
(630) 296-9566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

825 W State St Ste 119D
Geneva, IL 60134-2079

Mailing address

103 N 4TH Ave
Saint Charles, IL 60174-2001
Phone (630) 296-9566

Other names 1

  • Alexandra Gonzalez LCSW, LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

825 W State St
Ste 119D
Geneva, IL 60134
Phone (630) 296-9566

1250 Executive Pl
Ste 303
Geneva, IL 60134

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621555200000",
    "number": "1164980983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 N 4TH AVE",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601742001",
            "telephone_number": "630-296-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 W STATE ST STE 119D",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342079",
            "telephone_number": "630-296-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER GROWTH THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-11",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ-KONOPACKI",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-296-9566",
        "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": [
        {
            "organization_name": "Alexandra Gonzalez LCSW, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Geneva, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.