NPIMap

Organization Active NPI

Obsidian Institute of Integrative Medicine

  • Adult Mental Health Clinic/Center
  • Midlothian, IL
National Provider Identifier
1003795907
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
OBSIDIAN INSTITUTE OF INTEGRATIVE MEDICINE
Practice address
4720 147TH St
Midlothian, IL 60445-2527
Phone
(708) 433-9890
Fax
(888) 592-0804
NPI assigned
Aug 27, 2025
Last updated
Apr 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Authorized official

Name
Erica Washington, MA, LCPC, LMHC, NCCNPI 1144620139
Title
Director of Operations
Phone
(708) 462-2134

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

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

4720 147TH St
Midlothian, IL 60445-2527

Mailing address

4720 147TH St
Midlothian, IL 60445-2527
Phone (708) 704-0489

National Provider Directory

National Provider Directory
Tax ID family
Obsidian Institute of Integrative Medicine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

4720 147th St
Midlothian, IL 60445
Phone (708) 433-9890

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775088000000",
    "number": "1003795907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 147TH ST",
            "city": "MIDLOTHIAN",
            "state": "IL",
            "postal_code": "604452527",
            "telephone_number": "708-704-0489",
            "fax_number": "888-592-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 147TH ST",
            "city": "MIDLOTHIAN",
            "state": "IL",
            "postal_code": "604452527",
            "telephone_number": "708-433-9890",
            "fax_number": "888-592-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBSIDIAN INSTITUTE OF INTEGRATIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-27",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "708-462-2134",
        "authorized_official_credential": "MA, LCPC, LMHC, NCC"
    },
    "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 Midlothian, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; 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.