NPIMap

Organization Active NPI

Casey Tanner LLC

Doing business as The Expansive Group

  • Adult Mental Health Clinic/Center
  • Chicago, IL
National Provider Identifier
1093480592
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
CASEY TANNER LLC
Doing business as
The Expansive Group
Practice address
2210 W Wabansia Ave
Chicago, IL 60647-5477
Phone
(847) 849-9237
NPI assigned
Aug 16, 2021
Last updated
Aug 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Authorized official

Name
Casey Tanner, LCPCNPI 1396238242
Title
Managing Owner
Phone
(847) 849-9237

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinic/Center 261Q00000X
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

2210 W Wabansia Ave
Chicago, IL 60647-5477

Mailing address

2210 W Wabansia Ave
Chicago, IL 60647-5477

Other names 1

  • THE EXPANSIVE GROUP Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629072000000",
    "number": "1093480592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 W WABANSIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 W WABANSIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475477",
            "telephone_number": "847-849-9237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASEY TANNER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "MANAGING OWNER",
        "authorized_official_telephone_number": "847-849-9237",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE EXPANSIVE GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 16, 2021; 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.