Your Therapy S.P.a.C.E. LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

YOUR THERAPY S.P.A.C.E. LLC

Practice address

5113 S Harper Ave # 2079
Chicago, IL 60615-4119

Phone

(708) 803-2988

NPI assigned

Feb 28, 2023

Organization subpart

No

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

Authorized official

Name

Imani Alima Ibrahim, LCSWNPI 1023545464

Title

Owner

Phone

(630) 429-4356

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Imani Alima Ibrahim

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1023545464
  NPD Authorized official

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1265131262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5113 S HARPER AVE # 2079",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154119",
            "telephone_number": "708-803-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5113 S HARPER AVE # 2079",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154119",
            "telephone_number": "708-803-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR THERAPY S.P.A.C.E. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-28",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "IMANI ALIMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-429-4356",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Your Identity Counseling, PLLC (Your Identity Counseling)
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• Your Lifesmiles
• Your Mind Over Matters LLC
• Your Smile by Design, P.C.
• Your True Self LTD (Janet Katschke-Hansen)
• Your Turning Point PLLC
• Al-Yazeed Yousef, DMD
• Hadeel Yousef, DO
• Haila Yousef

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; 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.