Organization Active NPI

Kinzie Therapy & Consulting PLLC

  • Clinical Social Worker
  • Evanston, IL
National Provider Identifier
1083588636
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
KINZIE THERAPY & CONSULTING PLLC
Practice address
2530 Crawford Ave Ste 317
Evanston, IL 60201-4972
Phone
(847) 644-0940
NPI assigned
Oct 6, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Authorized official

Name
Dr. Taya Kinzie, LCSW, EDDNPI 1598656068
Title
Manager
Phone
(847) 644-0940

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
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2530 Crawford Ave Ste 317
Evanston, IL 60201-4972

Mailing address

3611 Hillside Rd
Evanston, IL 60201-4936
Phone (847) 644-0940

National Provider Directory

National Provider Directory

Locations

2530 Crawford Ave
Ste 317
Evanston, IL 60201
Phone (773) 817-8974

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": "1759708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759795200000",
    "number": "1083588636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 HILLSIDE RD",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014936",
            "telephone_number": "847-644-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CRAWFORD AVE STE 317",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014972",
            "telephone_number": "847-644-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINZIE THERAPY & CONSULTING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-06",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A",
        "authorized_official_last_name": "KINZIE",
        "authorized_official_first_name": "TAYA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-644-0940",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LCSW, EDD"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.