Associates for Innovative Change

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

ASSOCIATES FOR INNOVATIVE CHANGE

Practice address

210 S 5TH St Ste 103
St Charles, IL 60174-2700

Phone

(224) 678-9033

NPI assigned

Jul 8, 2017

Last updated

Jun 16, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kathryn R Juzwin, PSYD

Title

Clinical Psychologist

Phone

(224) 678-9033

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Natalie Pacini, LCSW

  • Clinical Social Worker
  • St Charles, IL
  • NPI 1821519471
  NPD (past)

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

{
    "created_epoch": "1499472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1205358579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S 5TH ST STE 103",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742700",
            "telephone_number": "224-678-9033",
            "fax_number": "224-678-9493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S 5TH ST STE 103",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742700",
            "telephone_number": "224-678-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATES FOR INNOVATIVE CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-08",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "JUZWIN",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "224-678-9033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL PSYCHOLOGIST",
            "identifier": "1518158948",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• At Your Service Psychiatry, PLLC (Psychiatry & Substance Abuse Treatment)

• Clinical Psychologist in St Charles, IL
• Providers in St Charles, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.