Individual provider Active NPI

Alexandra Gonzalez, LCSW

  • Clinical Social Worker
  • Geneva, IL
National Provider Identifier
1548426562
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149010362 Issued in IL
Practice address
825 W State St Ste 119D
Geneva, IL 60134-2079
Phone
(630) 296-9566
NPI assigned
Jul 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149010362 IL Primary

Addresses

Primary practice location

825 W State St Ste 119D
Geneva, IL 60134-2079

Mailing address

103 N 4TH Ave
Saint Charles, IL 60174-2001
Phone (630) 296-9566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149010362ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Growth Therapy Services, LLC Clinical CurrentSince May 25, 2021 Accepting new patients

Locations

825 W State St
Ste 119D
Geneva, IL 60134
Phone (630) 296-9566

1250 Executive Pl
Ste 303
Geneva, IL 60134

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1548426562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 N 4TH AVE",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601742001",
            "telephone_number": "630-296-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 W STATE ST STE 119D",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342079",
            "telephone_number": "630-296-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "ALEXANDRA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-29",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149010362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

Verify at the official NPI Registry.