NPIMap

Organization Active NPI

Your Story Counseling, P.C.

  • Clinical Social Worker
  • Lisle, IL
National Provider Identifier
1306248497
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.016945 Issued in IL
Legal business name
YOUR STORY COUNSELING, P.C.
Practice address
4745 Main St
Suite 207
Lisle, IL 60532-1754
Phone
(630) 442-1895
Fax
(630) 442-1896
NPI assigned
Sep 19, 2014
Last updated
Sep 30, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

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

Authorized official

Name
Mr. Clark Q Beckley, LCSWNPI 1194026443
Title
President
Phone
(630) 442-1895

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 149.016945 IL Primary

Addresses

Primary practice location

4745 Main St
Suite 207
Lisle, IL 60532-1754

Mailing address

4745 Main Street
Suite 207
Lisle, ILLINOIS 60532
UM
Phone (630) 442-1895

National Provider Directory

National Provider Directory

Locations

4745 Main St
Ste 207
Lisle, IL 60532
Phone (630) 442-1895

Practitioners & affiliated clinicians

Practitioners 33

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.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475193600000",
    "number": "1306248497",
    "addresses": [
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "4745 MAIN STREET",
            "address_2": "SUITE 207",
            "city": "LISLE",
            "state": "ILLINOIS",
            "postal_code": "60532",
            "telephone_number": "630-442-1895",
            "fax_number": "630-442-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 MAIN ST",
            "address_2": "SUITE 207",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321754",
            "telephone_number": "630-442-1895",
            "fax_number": "630-442-1896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR STORY COUNSELING, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-19",
        "last_updated": "2016-09-30",
        "status": "A",
        "authorized_official_last_name": "BECKLEY",
        "authorized_official_first_name": "CLARK",
        "authorized_official_middle_name": "Q",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-442-1895",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.016945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; 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.