NPIMap

Organization Active NPI

Balanced Awakening, PC

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1285024463
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071008952 Issued in IL
Legal business name
BALANCED AWAKENING, PC
Practice address
4043 N Ravenswood Ave Ste 302
Chicago, IL 60613-5683
Phone
(312) 967-4669
NPI assigned
Jan 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Authorized official

Name
Hannah Yang, PSY.D.
Title
Licensed Clinical Psychologist
Phone
(507) 407-4363

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 071008952 IL Primary

Addresses

Primary practice location

4043 N Ravenswood Ave Ste 302
Chicago, IL 60613-5683

Mailing address

4043 N Ravenswood Ave Ste 302
Chicago, IL 60613-5683
Phone (507) 407-4363

Other practice location 1

5215 N Ravenswood Ave
208
Chicago, IL 60640-1668
Phone (507) 407-4363

National Provider Directory

National Provider Directory

Locations

4043 N Ravenswood Ave
Ste 302
Chicago, IL 60613
Phone (312) 967-4669

Practitioners & affiliated clinicians

Practitioners 8

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": "1422316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1285024463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4043 N RAVENSWOOD AVE STE 302",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135683",
            "telephone_number": "507-407-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4043 N RAVENSWOOD AVE STE 302",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135683",
            "telephone_number": "312-967-4669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5215 N Ravenswood Ave",
            "address_2": "208",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606401668",
            "country_code": "US",
            "telephone_number": "507-407-4363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BALANCED AWAKENING, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-27",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "507-407-4363",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008952",
            "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 Feb 5, 2020; 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.