Authentic Living Therapeutic Services Inc

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

AUTHENTIC LIVING THERAPEUTIC SERVICES INC

Practice address

201 W Hiawatha Trail
Mt. Prospect, IL 60056-3763

Phone

(224) 567-3468

NPI assigned

Nov 16, 2023

Last updated

Apr 30, 2024By 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

Joyce Ann Gut, LCPCNPI 1366062655

Title

LCPC, Owner

Phone

(224) 567-3468

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

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.

• Joyce A Gut

  • Mental Health Counselor
  • Mount Prospect, IL
  • NPI 1366062655
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1700092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1093580482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W HIAWATHA TRAIL",
            "city": "MT. PROSPECT",
            "state": "IL",
            "postal_code": "600563763",
            "telephone_number": "224-567-3468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W HIAWATHA TRAIL",
            "city": "MT. PROSPECT",
            "state": "IL",
            "postal_code": "600563763",
            "telephone_number": "224-567-3468"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1750 E Golf Rd Ste 1112",
            "address_purpose": "LOCATION",
            "city": "Schaumburg",
            "state": "IL",
            "postal_code": "601735835",
            "country_code": "US",
            "telephone_number": "224-567-3468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AUTHENTIC LIVING THERAPEUTIC SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-16",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "GUT",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "LCPC, OWNER",
        "authorized_official_telephone_number": "224-567-3468",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Mount Prospect, IL
• Providers in Mount Prospect, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.