The Modern Wellness Collective, PLLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

THE MODERN WELLNESS COLLECTIVE, PLLC

Practice address

661 W Lake St Ste 2S
Chicago, IL 60661-1034

Phone

(419) 681-5889

NPI assigned

Sep 20, 2023

Organization subpart

No

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

Authorized official

Name

Kirsten Hall-Baldwin, LCPCNPI 1245889146

Title

Licensed Therapist

Phone

(419) 681-5889

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kirsten Ann Hall-Baldwin

  • Professional Counselor
  • Chicago, IL
  • NPI 1245889146
  NPD Authorized official

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

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730419200000",
    "number": "1164200093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 W LAKE ST STE 2S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606611034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 W LAKE ST STE 2S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606611034",
            "telephone_number": "419-681-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MODERN WELLNESS COLLECTIVE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-20",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A",
        "authorized_official_last_name": "HALL-BALDWIN",
        "authorized_official_first_name": "KIRSTEN",
        "authorized_official_title_or_position": "LICENSED THERAPIST",
        "authorized_official_telephone_number": "419-681-5889",
        "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": []
}

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• Adult Mental Health Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Adult Mental Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.