NPIMap

Organization Active NPI

Therapeutic Healing LLC

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1295124980
Registry record updated Jan 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.008016 Issued in IL
Legal business name
THERAPEUTIC HEALING LLC
Practice address
625 W Madison St Apt 4304
Chicago, IL 60661-2753
Phone
(312) 283-4475
NPI assigned
Jan 18, 2015
Last updated
Jan 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2015

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

Authorized official

Name
Dr. Mariam R Mourad, PH.D.
Title
Psychologist
Phone
(312) 283-4475

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.008016 IL Primary

Addresses

Primary practice location

625 W Madison St Apt 4304
Chicago, IL 60661-2753

Mailing address

625 W Madison St Apt 4304
Chicago, IL 60661-2753
Phone (517) 483-3424

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1421539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421539200000",
    "number": "1295124980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 W MADISON ST APT 4304",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606612753",
            "telephone_number": "517-483-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W MADISON ST APT 4304",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606612753",
            "telephone_number": "312-283-4475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC HEALING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-18",
        "last_updated": "2015-01-18",
        "status": "A",
        "authorized_official_last_name": "MOURAD",
        "authorized_official_first_name": "MARIAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "312-283-4475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.008016",
            "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 Jan 18, 2015; 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.