Active NPI
Bakahia Madison, PSYD
- Professional Counselor
- Chicago, IL
National Provider Identifier
1083178776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180010155
- Practice address
- 400 W 76TH St Ste 324
Chicago, IL 60620-1640 - Phone
- (773) 673-7636
- NPI assigned
- Jan 26, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180010155 | IL | Primary |
Addresses
Primary practice location
400 W 76TH St Ste 324
Chicago, IL 60620-1640
Mailing address
400 W 76TH St Ste 324
Chicago, IL 60620-1640
Phone (773) 673-7636
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180010155 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nia Services Nfo | Professional | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548460800000",
"number": "1083178776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 W 76TH ST STE 324",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606201640",
"telephone_number": "773-673-7636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 W 76TH ST STE 324",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606201640",
"telephone_number": "773-673-7636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADISON",
"first_name": "BAKAHIA",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-26",
"last_updated": "2019-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180010155",
"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 Jan 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.