Organization Active NPI

Chicago Center for Growth and Change, LLC

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1255793360
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071008093 Issued in IL
Legal business name
CHICAGO CENTER FOR GROWTH AND CHANGE, LLC
Practice address
25 E Washington St Ste 1717
Chicago, IL 60602-1839
Phone
(312) 566-8536
NPI assigned
Mar 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Authorized official

Name
Dr. Jodie Erin Singer, PSY.D., M.A.NPI 1720394356
Title
Clinical Psychologist
Phone
(312) 566-8536

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 071008093 IL Primary

Addresses

Primary practice location

25 E Washington St Ste 1717
Chicago, IL 60602-1839

Mailing address

5246 W Carmen Ave
Chicago, IL 60630-2211
Phone (312) 566-8536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170220000403 IL Part B Supplier - Clinic/Group Practice 3678856598 Receives reassigned benefits from 2 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

150 N Michigan Ave
Ste 800
Chicago, IL 60601
Phone (312) 566-8536

Practitioners & affiliated clinicians

Practitioners 3

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": "1459123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689897600000",
    "number": "1255793360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5246 W CARMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302211",
            "telephone_number": "312-566-8536",
            "fax_number": "888-416-1729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E WASHINGTON ST STE 1717",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021839",
            "telephone_number": "312-566-8536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO CENTER FOR GROWTH AND CHANGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-28",
        "last_updated": "2023-07-21",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "SINGER",
        "authorized_official_first_name": "JODIE",
        "authorized_official_middle_name": "ERIN",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "312-566-8536",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D., M.A."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008093",
            "primary": true
        }
    ],
    "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 Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.