Sista Afya Community Mental Wellness LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SISTA AFYA COMMUNITY MENTAL WELLNESS LLC

Practice address

1817 E 71St St
Chicago, IL 60649-2000

Phone

(773) 234-7994

NPI assigned

Apr 2, 2019

Last updated

Mar 7, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Camesha Lynette Jones, LCSW

Title

LCSW/Executive Director

Phone

(773) 234-7994

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Camesha Lynette Jones- Brandon, LCSW

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1790261907
  NPD

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615075200000",
    "number": "1255893939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 E 61ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606372406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 E 71ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606492000",
            "telephone_number": "773-234-7994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISTA AFYA COMMUNITY MENTAL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-02",
        "last_updated": "2021-03-07",
        "certification_date": "2021-03-07",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CAMESHA",
        "authorized_official_middle_name": "LYNETTE",
        "authorized_official_title_or_position": "LCSW/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "773-234-7994",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Katherine Sisson-Smith
• Alan L. Sisson, M.D.
• George Sisson Jr., MD
• Sista Afya Community Care NFP
• Sista Afya Community Care NFP
• Kenneth Mark Sistino, D.C.
• Amy Siston, PH.D.
• Charles Sisung, MD
• Dorothy K. Sit, M.D.
• Phyllis Marie Sit, APN, CRNA

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2021; 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.