Individual provider Active NPI

Mayra Soto-Gonzalez, LCSW

  • Clinical Social Worker
  • Oak Park, IL
National Provider Identifier
1942478342
Registry record updated Jul 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-009468 Issued in IL
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, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2011

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 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

IdentifierTypeStateIssuer
1637084OtherILBCBSIL

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
149-009468ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.