NPIMap

Organization Active NPI

Psychwise Services LLC

  • Clinical Social Worker
  • Grayslake, IL
National Provider Identifier
1093265043
Registry record updated Oct 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149004268 Issued in IL
Legal business name
PSYCHWISE SERVICES LLC
Practice address
34121 N US Highway 45 Ste 222
Grayslake, IL 60030-1774
Phone
(847) 826-7702
Fax
(888) 393-7595
NPI assigned
Oct 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2016

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

Authorized official

Name
Felicia Michele Glick, LCSW
Title
Managing Owner
Phone
(847) 826-7702

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 149004268 IL Primary

Addresses

Primary practice location

34121 N US Highway 45 Ste 222
Grayslake, IL 60030-1774

Mailing address

1305 Cromwell CT
Vernon Hills, IL 60061-1214
Phone (847) 826-7702

National Provider Directory

National Provider Directory

Locations

34121 N US Highway 45
Ste 222
Grayslake, IL 60030
Phone (224) 430-9804

NPI Registry JSON

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476316800000",
    "number": "1093265043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 CROMWELL CT",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611214",
            "telephone_number": "847-826-7702",
            "fax_number": "888-393-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34121 N US HIGHWAY 45 STE 222",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600301774",
            "telephone_number": "847-826-7702",
            "fax_number": "888-393-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHWISE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-13",
        "last_updated": "2016-10-13",
        "status": "A",
        "authorized_official_last_name": "GLICK",
        "authorized_official_first_name": "FELICIA",
        "authorized_official_middle_name": "MICHELE",
        "authorized_official_title_or_position": "MANAGING OWNER",
        "authorized_official_telephone_number": "847-826-7702",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149004268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayslake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; 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.