Inner Sun Psychotherapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149-019001 Issued in IL

Legal business name

INNER SUN PSYCHOTHERAPY, LLC

Practice address

53 W Jackson Blvd
Suite 1625
Chicago, IL 60604-3606

Phone

(773) 892-4340

NPI assigned

Mar 20, 2017

Last updated

Mar 20, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Barry Shaeffer, LCSW

Title

Owner

Phone

(773) 892-4340

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489968000000",
    "number": "1083155360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 W JACKSON BLVD",
            "address_2": "SUITE 1625",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 W JACKSON BLVD",
            "address_2": "SUITE 1625",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043606",
            "telephone_number": "773-892-4340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER SUN PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-20",
        "last_updated": "2017-03-20",
        "status": "A",
        "authorized_official_last_name": "SHAEFFER",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-892-4340",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-019001",
            "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 Mar 20, 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.