Restorative Collective LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

RESTORATIVE COLLECTIVE LLC

Practice address

2650 W Montrose Ave Ste 307
Chicago, IL 60618-1561

Phone

(773) 217-9249

NPI assigned

Dec 22, 2021

Organization subpart

No

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

Authorized official

Name

Tia CochranNPI 1760042949

Title

Co-Owner

Phone

(314) 620-9148

Specialties & licenses 2

Addresses

Practitioners 1

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

• Tia Lynae Cochran

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1760042949
  NPD Authorized official

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

{
    "created_epoch": "1640131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649808000000",
    "number": "1215697974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 UPLAND DR # 6900",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770434718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 W MONTROSE AVE STE 307",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181561",
            "telephone_number": "773-217-9249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATIVE COLLECTIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-22",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A",
        "authorized_official_last_name": "COCHRAN",
        "authorized_official_first_name": "TIA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "314-620-9148"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; 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.