NPIMap

Organization Active NPI

Matthew Marx Therapy, PLLC

  • Adult Mental Health Clinic/Center
  • Evanston, IL
National Provider Identifier
1104560036
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
MATTHEW MARX THERAPY, PLLC
Practice address
1509 Oak Ave Apt 3N
Evanston, IL 60201-4263
Phone
(920) 221-9691
NPI assigned
Apr 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Authorized official

Name
Matthew Robert Marx, LCPCNPI 1689145534
Title
Owner/Therapist
Phone
(920) 221-9691

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
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

1509 Oak Ave Apt 3N
Evanston, IL 60201-4263

Mailing address

1509 Oak Ave Apt 3N
Evanston, IL 60201-4263
Phone (920) 221-9691

National Provider Directory

National Provider Directory

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": "1650931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650931200000",
    "number": "1104560036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 OAK AVE APT 3N",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014263",
            "telephone_number": "920-221-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 OAK AVE APT 3N",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014263",
            "telephone_number": "920-221-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW MARX THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-26",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A",
        "authorized_official_last_name": "MARX",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "920-221-9691",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "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 Apr 26, 2022; 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.