Organization Active NPI

Miracleworks Therapy & Consulting Inc

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1003600511
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MIRACLEWORKS THERAPY & CONSULTING INC
Practice address
51 E 14TH St Apt 1008
Chicago, IL 60605-2998
Phone
(310) 849-4786
Fax
(872) 250-2826
NPI assigned
Apr 8, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Authorized official

Name
Miracle D Montgomery, LCSW
Title
Licensed Clinical Social Worker
Phone
(310) 849-4786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

51 E 14TH St Apt 1008
Chicago, IL 60605-2998

Mailing address

51 E 14TH St Apt 1008
Chicago, IL 60605-2998
Phone (310) 849-4786

Other names 1

  • N/A Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250501000783 IL Part B Supplier - Clinic/Group Practice 6002332152 Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1744070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744070400000",
    "number": "1003600511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 E 14TH ST APT 1008",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052998",
            "telephone_number": "310-849-4786",
            "fax_number": "872-250-2826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 E 14TH ST APT 1008",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052998",
            "telephone_number": "310-849-4786",
            "fax_number": "872-250-2826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLEWORKS THERAPY & CONSULTING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "MIRACLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "310-849-4786",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "N/A",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.