NPIMap

Organization Active NPI

Carolina Therapeutic Services Community Development Inc

  • Adult Mental Health Clinic/Center
  • Chicago, IL
National Provider Identifier
1003609322
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
CAROLINA THERAPEUTIC SERVICES COMMUNITY DEVELOPMENT INC
Practice address
3015 W Harrison St Unit 1
Chicago, IL 60612-3342
Phone
(704) 864-1477
NPI assigned
May 28, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Authorized official

Name
Crystal Cancel
Title
Director of Operations
Phone
(773) 698-4688

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

3015 W Harrison St Unit 1
Chicago, IL 60612-3342

Mailing address

1528 Union Rd
Gastonia, NC 28054-2200
Phone (704) 864-1477

National Provider Directory

National Provider Directory
Tax ID family
Carolina Therapeutic Services Community Development Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1748390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765411200000",
    "number": "1003609322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 UNION RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542200",
            "telephone_number": "704-864-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 W HARRISON ST UNIT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123342",
            "telephone_number": "704-864-1477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA THERAPEUTIC SERVICES COMMUNITY DEVELOPMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A",
        "authorized_official_last_name": "CANCEL",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "773-698-4688"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Dec 11, 2025; 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.