NPIMap

Organization Active NPI

PWP Health, LLC

  • Adult Mental Health Clinic/Center
  • Chicago, IL
National Provider Identifier
1235704735
Registry record updated Nov 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
PWP HEALTH, LLC
Practice address
2930 West Grand Ave
Chicago, IL 60622
Phone
(872) 817-9858
Fax
(773) 661-6993
NPI assigned
May 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2022

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

Authorized official

Name
Yolanda Stone
Title
Co-Owner
Phone
(434) 608-2618

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

2930 West Grand Ave
Chicago, IL 60622

Mailing address

621 Broad St
Altavista, VA 24517-1855
Phone (434) 608-2618

National Provider Directory

National Provider Directory
Tax ID family
PWP Health LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2930 W Grand Ave
Chicago, IL 60622
Phone (773) 704-5107

Practitioners & affiliated clinicians

Practitioners 7

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": "1621987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669334400000",
    "number": "1235704735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 BROAD ST",
            "city": "ALTAVISTA",
            "state": "VA",
            "postal_code": "245171855",
            "telephone_number": "434-608-2618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 WEST GRAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60622",
            "telephone_number": "872-817-9858",
            "fax_number": "773-661-6993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PWP HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-26",
        "last_updated": "2022-11-25",
        "certification_date": "2022-11-18",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "YOLANDA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "434-608-2618"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Nov 25, 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.