Organization Active NPI

Positively Psyched, PLLC

  • Clinical Social Worker
  • La Grange, IL
National Provider Identifier
1043972854
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
POSITIVELY PSYCHED, PLLC
Practice address
17 N Catherine Ave
La Grange, IL 60525-5929
Phone
(630) 244-2679
NPI assigned
Oct 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Authorized official

Name
Scott Lestina
Title
Office Administrator
Phone
(630) 244-2679

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

17 N Catherine Ave
La Grange, IL 60525-5929

Mailing address

17 N Catherine Ave
La Grange, IL 60525-5929

Other identifiers 2

IdentifierTypeStateIssuer
1942667530OtherILCIGNA/PPO
1942667530OtherILBCBS/PPO

National Provider Directory

National Provider Directory

Locations

17 N Catherine Ave
La Grange, IL 60525
Phone (708) 247-5827

Practitioners & affiliated clinicians

Practitioners 2

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": "1633651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703203200000",
    "number": "1043972854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 N CATHERINE AVE",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605255929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 N CATHERINE AVE",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605255929",
            "telephone_number": "630-244-2679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POSITIVELY PSYCHED, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-08",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A",
        "authorized_official_last_name": "LESTINA",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "630-244-2679"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA/PPO",
            "identifier": "1942667530",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS/PPO",
            "identifier": "1942667530",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; 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.