International Behavioral Health

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149014748 Issued in IL

Legal business name

INTERNATIONAL BEHAVIORAL HEALTH

Practice address

10448 S Pulaski Rd
Suite 4
Oak Lawn, IL 60453-4895

Phone

(312) 834-3697

NPI assigned

Sep 9, 2011

Organization subpart

No

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

Authorized official

Name

Crystal Smith, IMFT, LCSW

Title

Director

Phone

(312) 554-9934

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472169600000",
    "number": "1225310865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 E 61ST ST",
            "address_2": "1N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606372973",
            "telephone_number": "312-554-9934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10448 S PULASKI RD",
            "address_2": "SUITE 4",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604534895",
            "telephone_number": "312-834-3697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-09",
        "last_updated": "2016-08-26",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "312-554-9934",
        "authorized_official_credential": "IMFT, LCSW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "20992",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "180007270",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149014748",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "IMFT-125",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2016; 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.