Individual provider Active NPI

Bonita R Guerra, LCPC

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1578735593
Registry record updated May 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180001716 Issued in IL
Practice address
3020 N Kimball Ave
Chicago, IL 60618-6812
Phone
(773) 416-4453
NPI assigned
Mar 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180001716 IL Primary

Addresses

Primary practice location

3020 N Kimball Ave
Chicago, IL 60618-6812

Mailing address

6037 N Fairfield
First Floor
Chicago, IL 60659
Phone (773) 416-4453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
180001716ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1578735593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6037 N FAIRFIELD",
            "address_2": "FIRST FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60659",
            "telephone_number": "773-416-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 N KIMBALL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186812",
            "telephone_number": "773-416-4453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRA",
        "first_name": "BONITA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-31",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180001716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; 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.