NPIMap

Organization Active NPI

Beacon Therapy, PLLC

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1073361226
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
BEACON THERAPY, PLLC
Practice address
2500 W Bradley PL Ste 100
Chicago, IL 60618-4716
Phone
(708) 794-6898
NPI assigned
May 10, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Authorized official

Name
Charlie DavittNPI 1548861008
Title
Owner - Mental Health Therapist
Phone
(630) 995-6837

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
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

2500 W Bradley PL Ste 100
Chicago, IL 60618-4716

Mailing address

3105 W Lawrence Ave Apt 3
Chicago, IL 60625-7451

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1715299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715299200000",
    "number": "1073361226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 W LAWRENCE AVE APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606257451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W BRADLEY PL STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606184716",
            "telephone_number": "708-794-6898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-10",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A",
        "authorized_official_last_name": "DAVITT",
        "authorized_official_first_name": "CHARLIE",
        "authorized_official_title_or_position": "OWNER - MENTAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "630-995-6837"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "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 May 10, 2024; 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.