NPIMap

Organization Active NPI

Brave Talk Therapy PLLC

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1033849807
Registry record updated Jul 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
BRAVE TALK THERAPY PLLC
Doing business as
Brave Talk Therapy
Practice address
4938 W Gunnison St
Chicago, IL 60630-2413
Phone
(773) 550-3302
NPI assigned
Jun 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2022

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

Authorized official

Name
Lauren Ludlow, LCSWNPI 1437580370
Title
Owner/ LCSW
Phone
(773) 550-3302

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

4938 W Gunnison St
Chicago, IL 60630-2413

Mailing address

4938 W Gunnison St
Chicago, IL 60630-2413
Phone (773) 550-3302

Other names 1

  • Brave Talk Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

6440 N Central Ave
Chicago, IL 60646
Phone (608) 618-4243

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659139200000",
    "number": "1033849807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4938 W GUNNISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302413",
            "telephone_number": "773-550-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4938 W GUNNISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302413",
            "telephone_number": "773-550-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVE TALK THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-07-30",
        "certification_date": "2022-07-30",
        "status": "A",
        "authorized_official_last_name": "LUDLOW",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "OWNER/ LCSW",
        "authorized_official_telephone_number": "773-550-3302",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brave Talk Therapy",
            "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 Jul 30, 2022; 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.