Organization Active NPI

Ember & Rise Therapy Group, PLLC

  • Clinical Social Worker
  • Naperville, IL
National Provider Identifier
1205749421
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
EMBER & RISE THERAPY GROUP, PLLC
Practice address
1315 Macom Dr Ste 207
Naperville, IL 60564-9361
Phone
(630) 256-8929
NPI assigned
Sep 28, 2026
Last updated
Sep 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Authorized official

Name
Laura Provancal, LCSW
Title
Owner
Phone
(630) 202-7232

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

1315 Macom Dr Ste 207
Naperville, IL 60564-9361

Mailing address

2S345 Arrowhead Dr
Wheaton, IL 60189-1603
Phone (630) 202-7232

NPI Registry JSON

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

{
    "created_epoch": "1790553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790553600000",
    "number": "1205749421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2S345 ARROWHEAD DR",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601891603",
            "telephone_number": "630-202-7232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 MACOM DR STE 207",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605649361",
            "telephone_number": "630-256-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBER & RISE THERAPY GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-28",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A",
        "authorized_official_last_name": "PROVANCAL",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-202-7232",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.