Organization Active NPI

Behavior and Mood Clinic

  • Counselor
  • Chicago, IL
National Provider Identifier
1003978743
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
BEHAVIOR AND MOOD CLINIC
Practice address
1116 N Kedzie Ave
Suite 524
Chicago, IL 60651-4152
Phone
(773) 750-9773
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Daniel W. Bishop, LCPC
Title
President
Phone
(773) 750-9773

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X IL Primary

Addresses

Primary practice location

1116 N Kedzie Ave
Suite 524
Chicago, IL 60651-4152

Mailing address

1116 N Kedzie Ave
Suite 524
Chicago, IL 60651-4152
Phone (773) 750-9773

National Provider Directory

National Provider Directory

Locations

1116 N Kedzie Ave
Ste 524
Chicago, IL 60651
Phone (773) 750-9773

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003978743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 N KEDZIE AVE",
            "address_2": "SUITE 524",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606514152",
            "telephone_number": "773-750-9773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 N KEDZIE AVE",
            "address_2": "SUITE 524",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606514152",
            "telephone_number": "773-750-9773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIOR AND MOOD CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BISHOP",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-750-9773",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "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 Aug 22, 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.