NPIMap

Organization Active NPI

Lotus Trauma Care, LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Chicago, IL
National Provider Identifier
1083139406
Registry record updated Aug 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
LOTUS TRAUMA CARE, LLC
Practice address
503 E 61St St
Chicago, IL 60637-2406
Phone
(872) 233-8207
NPI assigned
Aug 7, 2017
Last updated
Aug 7, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2017

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

Authorized official

Name
Mrs. Chauntay Brenord, LCSW
Title
Co-Founder, Trauma Therapist
Phone
(630) 201-0838

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X
Community/Behavioral Health Agency 251S00000X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

503 E 61St St
Chicago, IL 60637-2406

Mailing address

503 E 61St St
Chicago, IL 60637-2406

National Provider Directory

National Provider Directory

Locations

2151 W 79th St
Ste 2
Chicago, IL 60620
Phone (312) 757-0608

503 E 61st St
Chicago, IL 60637
Phone (708) 299-1034

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1502064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502064000000",
    "number": "1083139406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 E 61ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606372406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 E 61ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606372406",
            "telephone_number": "872-233-8207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOTUS TRAUMA CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-07",
        "last_updated": "2017-08-07",
        "status": "A",
        "authorized_official_last_name": "BRENORD",
        "authorized_official_first_name": "CHAUNTAY",
        "authorized_official_title_or_position": "CO-FOUNDER, TRAUMA THERAPIST",
        "authorized_official_telephone_number": "630-201-0838",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "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 Aug 7, 2017; 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.