Active NPI
Mayra Soto-Gonzalez, LCSW
- Clinical Social Worker
- Oak Park, IL
National Provider Identifier
1942478342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149-009468
- Practice address
- 1111 Westgate
Westgate Business Center, Suite 116
Oak Park, IL 60301 - Phone
- (312) 388-4273
- Fax
- (312) 268-5044
- NPI assigned
- Feb 19, 2008
- Last updated
- Jul 15, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149-009468 | IL | Primary |
Addresses
Primary practice location
1111 Westgate
Westgate Business Center, Suite 116
Oak Park, IL 60301
Mailing address
1111 Westgate
Westgate Business Center, Suite 116
Oak Park, IL 60301
Phone (312) 388-4273
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1637084 | Other | IL | BCBSIL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 149-009468 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Goso Consulting, Inc. | Clinical | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Social Worker
- Oak Park, IL
- NPI 1134319643
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310688000000",
"number": "1942478342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 WESTGATE",
"address_2": "WESTGATE BUSINESS CENTER, SUITE 116",
"city": "OAK PARK",
"state": "IL",
"postal_code": "60301",
"telephone_number": "312-388-4273",
"fax_number": "312-268-5044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 WESTGATE",
"address_2": "WESTGATE BUSINESS CENTER, SUITE 116",
"city": "OAK PARK",
"state": "IL",
"postal_code": "60301",
"telephone_number": "312-388-4273",
"fax_number": "312-268-5044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOTO-GONZALEZ",
"first_name": "MAYRA",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-19",
"last_updated": "2011-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149-009468",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSIL",
"identifier": "1637084",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Oak Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.