Agave Studio for Psychotherapy and Spiritual Direction

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.008116 Issued in IL

Legal business name

AGAVE STUDIO FOR PSYCHOTHERAPY AND SPIRITUAL DIRECTION

Practice address

2950 W Chicago Ave
#302
Chicago, IL 60622-4375

Phone

(773) 627-2112

NPI assigned

Jul 2, 2012

Last updated

Jul 2, 2012By 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

Dr. Janeil Irene Ruiz, PSY.D.

Title

Executive Director and Founder

Phone

(773) 627-2112

Specialties & licenses 3

Addresses

Locations

Practitioners 1

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.

• Janeil Nellis Ruiz, PSY.D.

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1033306451
  NPD (past)

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341187200000",
    "number": "1093079212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 N ARTESIAN AVE # 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222935",
            "telephone_number": "773-627-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 W CHICAGO AVE",
            "address_2": "#302",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224375",
            "telephone_number": "773-627-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAVE STUDIO FOR PSYCHOTHERAPY AND SPIRITUAL DIRECTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-02",
        "last_updated": "2012-07-02",
        "status": "A",
        "authorized_official_last_name": "RUIZ",
        "authorized_official_first_name": "JANEIL",
        "authorized_official_middle_name": "IRENE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR AND FOUNDER",
        "authorized_official_telephone_number": "773-627-2112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.008116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rita Agarwala, MD
• Kristina Agase, APN-CNP
• Luke William Agase, PA-C
• Agate Psychotherapy
• Taylor N Agate, PA-C
• Agave Studio, LLC
• Oreoluwatomi Agbaje, NURSE PRACTITIONER
• Prince Amechi Agbakahi, MD
• Aira Louise Padua Agbayani
• Theodore Lord Agbemaple, MD

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; 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.