Innerwork Wellness, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

INNERWORK WELLNESS, LLC

Practice address

4909 Cypress CT
Richton Park, IL 60471-1602

Phone

(312) 898-5007

NPI assigned

Jun 10, 2022

Last updated

Jun 10, 2022By 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

Tolaya Geredine, LCPCNPI 1982156550

Title

Owner

Phone

(312) 898-5007

Specialties & licenses 1

Addresses

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.

• Tolaya Geredine, LCPC

  • Professional Counselor
  • Flossmoor, IL
  • NPI 1982156550
  NPD Authorized official

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654819200000",
    "number": "1225767544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 CYPRESS CT",
            "city": "RICHTON PARK",
            "state": "IL",
            "postal_code": "604711602",
            "telephone_number": "312-898-5007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4909 CYPRESS CT",
            "city": "RICHTON PARK",
            "state": "IL",
            "postal_code": "604711602",
            "telephone_number": "312-898-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNERWORK WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A",
        "authorized_official_last_name": "GEREDINE",
        "authorized_official_first_name": "TOLAYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-898-5007",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addison Jackson Jr., LCSW
• Lauren Michelle Jackson, LPC

• Community/Behavioral Health Agency in Richton Park, IL
• Providers in Richton Park, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.