Transformative Psychotherapy LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149002037 Issued in IL

Legal business name

TRANSFORMATIVE PSYCHOTHERAPY LLC

Practice address

4753 N Broadway St
830
Chicago, IL 60640-5266

Phone

(773) 484-5186

NPI assigned

Sep 13, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Lisa J. Rivitz, LCSW

Title

Manager

Phone

(773) 484-5186

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379376000000",
    "number": "1063847622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 W LELAND AVE",
            "address_2": "#310",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407100",
            "telephone_number": "773-484-5186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4753 N BROADWAY ST",
            "address_2": "830",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405266",
            "telephone_number": "773-484-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSFORMATIVE PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-13",
        "last_updated": "2013-09-17",
        "status": "A",
        "authorized_official_last_name": "RIVITZ",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-484-5186",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149002037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.