NPIMap

Organization Active NPI

Lincoln Park Therapy Group

  • Marriage & Family Therapist
  • Chicago, IL
National Provider Identifier
1144672908
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
166000873 Issued in IL
Legal business name
LINCOLN PARK THERAPY GROUP
Practice address
2755 N Pine Grove Ave
Chicago, IL 60614-6109
Phone
(312) 259-2665
NPI assigned
Jul 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Authorized official

Name
Mrs. Nicolle Alodia Molina Osequeda, LMFTNPI 1437331428
Title
Owner/Psychotherapist
Phone
(312) 259-2665

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
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X 166000873 IL Primary

Addresses

Primary practice location

2755 N Pine Grove Ave
Chicago, IL 60614-6109

Mailing address

2755 N Pine Grove Ave
Chicago, IL 60614-6109
Phone (312) 259-2665

Other practice location 1

3139 N Lincoln Ave Ste 228
Chicago, IL 60657-3173
Phone (312) 259-2665

National Provider Directory

National Provider Directory
Tax ID family
Lincoln Park Therapy Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3139 N Lincoln Ave
Ste 228
Chicago, IL 60657
Phone (312) 259-2665

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611532800000",
    "number": "1144672908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2755 N PINE GROVE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606146109",
            "telephone_number": "312-259-2665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 N PINE GROVE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606146109",
            "telephone_number": "312-259-2665"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3139 N Lincoln Ave Ste 228",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606573173",
            "country_code": "US",
            "telephone_number": "312-259-2665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LINCOLN PARK THERAPY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-05",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A",
        "authorized_official_last_name": "OSEQUEDA",
        "authorized_official_first_name": "NICOLLE",
        "authorized_official_middle_name": "ALODIA MOLINA",
        "authorized_official_title_or_position": "OWNER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "312-259-2665",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166000873",
            "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 Jan 25, 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.