Individual provider Active NPI

Genevieve Rose Hebeka, LCSW

  • Clinical Social Worker
  • Saint Charles, IL
National Provider Identifier
1174937098
Registry record updated Jun 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149 011261 Issued in IL
Practice address
320 Beatrice Ave
Saint Charles, IL 60174-4344
Phone
(773) 633-3086
NPI assigned
Jun 18, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149 011261 IL Primary

Addresses

Primary practice location

320 Beatrice Ave
Saint Charles, IL 60174-4344

Mailing address

320 Beatrice Ave
Saint Charles, IL 60174-4344
Phone (773) 633-3086

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149 011261ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1174937098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 BEATRICE AVE",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601744344",
            "telephone_number": "773-633-3086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 BEATRICE AVE",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601744344",
            "telephone_number": "773-633-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBEKA",
        "first_name": "GENEVIEVE",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-18",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149 011261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2014; 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.