Organization Active NPI

Alex Tavlas Therapy PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
National Provider Identifier
1124836903
Registry record updated Dec 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
ALEX TAVLAS THERAPY PLLC
Practice address
2933 N Kedzie Ave
Chicago, IL 60618-7603
Phone
(708) 292-8798
NPI assigned
Dec 24, 2024
Last updated
Dec 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2024

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

Authorized official

Name
Alexandra Tavlas, LCPCNPI 1679381446
Title
Therapist
Phone
(708) 292-8798

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
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

2933 N Kedzie Ave
Chicago, IL 60618-7603

Mailing address

2933 N Kedzie Ave
Chicago, IL 60618-7603
Phone (708) 292-8798

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, 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": "1734998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734998400000",
    "number": "1124836903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2933 N KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606187603",
            "telephone_number": "708-292-8798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2933 N KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606187603",
            "telephone_number": "708-292-8798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEX TAVLAS THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-24",
        "last_updated": "2024-12-24",
        "certification_date": "2024-12-24",
        "status": "A",
        "authorized_official_last_name": "TAVLAS",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "708-292-8798",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 24, 2024; 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.