Inkwell Psychotherapy

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

INKWELL PSYCHOTHERAPY

Practice address

4305 N Lincoln Ave Ste L
Chicago, IL 60618-1807

Phone

(773) 669-4975

Fax

(844) 669-3667

NPI assigned

Feb 7, 2020

Last updated

Feb 7, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephanie M Fowler, LCPC, CADCNPI 1770954877

Title

Owner, Therapist

Phone

(773) 669-4975

Specialties & licenses 3

Addresses

Locations

Practitioners 1

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.

• Stephanie Fowler, LCPC, CADC

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1770954877

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581033600000",
    "number": "1942832977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 N LINCOLN AVE STE L",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181807",
            "telephone_number": "773-669-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 N LINCOLN AVE STE L",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181807",
            "telephone_number": "773-669-4975",
            "fax_number": "844-669-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INKWELL PSYCHOTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER, THERAPIST",
        "authorized_official_telephone_number": "773-669-4975",
        "authorized_official_credential": "LCPC, CADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maira A Iniguez, LCPC
• Mayra Alejandra Iniguez, LSW
• Reniell Xavier Iniguez
• Sebastian Iniguez, MD
• Initium Inc.
• Inna Goldberg OD PC
• Inner Arts, Inc
• Inner Balance Counseling
• Inner Balance Psychotherapy Services LTD
• Inner Balance Therapy

• Mental Health Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; 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.