Lincoln Square Mindful Therapy

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180006375 Issued in IL

Legal business name

LINCOLN SQUARE MINDFUL THERAPY

Practice address

4732 N Lincoln Ave
Chicago, IL 60625-8561

Phone

(312) 399-0559

NPI assigned

Jun 8, 2015

Organization subpart

No

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

Authorized official

Name

Elizabeth Tobin, M.ED., LCPC, LMFT

Title

President

Phone

(312) 399-0559

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1174903736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4732 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606258561",
            "telephone_number": "312-399-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4732 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606258561",
            "telephone_number": "312-399-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN SQUARE MINDFUL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-08",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "TOBIN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-399-0559",
        "authorized_official_credential": "M.ED., LCPC, LMFT"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180006375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lincoln Park Therapy Group
• Lincoln Pediatric Center, PC
• Lincoln Smiles Family Dentistry
• Lincoln Square Dental Associates, LTD.
• Lincoln Square Medical Associates, LTD.
• Lincoln Square Optical
• Lincoln Square Orthodontics
• Renetta Denise Lincoln-Stallworth, LPN
• Christy Ann Lincoln, LCPC
• Keirstin Lincoln, LPC

• Professional Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.