NPIMap

Organization Active NPI

Freestone Psychotherapy LLC

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1144686122
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149015772 Issued in IL
Legal business name
FREESTONE PSYCHOTHERAPY LLC
Practice address
4619 N Ravenswood Ave
Suite 303C
Chicago, IL 60640-4580
Phone
(312) 834-7778
NPI assigned
Jan 6, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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

Authorized official

Name
Kevin Barrett, LCSWNPI 1821360397
Title
Manager
Phone
(312) 834-7778

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
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 149015772 IL Primary

Addresses

Primary practice location

4619 N Ravenswood Ave
Suite 303C
Chicago, IL 60640-4580

Mailing address

4619 N Ravenswood Ave
Suite 303C
Chicago, IL 60640-4580
Phone (312) 834-7778

National Provider Directory

National Provider Directory

Locations

4619 N Ravenswood Ave
Ste 303C
Chicago, IL 60640
Phone (312) 834-7778

Practitioners & affiliated clinicians

Practitioners 2

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": "1452038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490659200000",
    "number": "1144686122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4619 N RAVENSWOOD AVE",
            "address_2": "SUITE 303C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404580",
            "telephone_number": "312-834-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4619 N RAVENSWOOD AVE",
            "address_2": "SUITE 303C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404580",
            "telephone_number": "312-834-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREESTONE PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-06",
        "last_updated": "2017-03-28",
        "status": "A",
        "authorized_official_last_name": "BARRETT",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "312-834-7778",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015772",
            "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 Mar 28, 2017; 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.