Active NPI
Gol Relational Center, PLLC
- Mental Health Counselor
- Chicago, IL
National Provider Identifier
1295371367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- GOL RELATIONAL CENTER, PLLC
- Practice address
- 4611 N Ravenswood Ave Ste 205
Chicago, IL 60640-7577 - Phone
- (773) 366-4901
- NPI assigned
- Nov 22, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Fateme Targol Hasankhani
- Title
- LMFT
- Phone
- (773) 366-4901
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary | ||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X |
Addresses
Primary practice location
4611 N Ravenswood Ave Ste 205
Chicago, IL 60640-7577
Mailing address
4611 N Ravenswood Ave Ste 205
Chicago, IL 60640-7577
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
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": "1574380800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1702166400000",
"number": "1295371367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4611 N RAVENSWOOD AVE STE 205",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606407577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4611 N RAVENSWOOD AVE STE 205",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606407577",
"telephone_number": "773-366-4901"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GOL RELATIONAL CENTER, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-11-22",
"last_updated": "2023-12-10",
"certification_date": "2023-12-10",
"status": "A",
"authorized_official_last_name": "HASANKHANI",
"authorized_official_first_name": "FATEME",
"authorized_official_middle_name": "TARGOL",
"authorized_official_title_or_position": "LMFT",
"authorized_official_telephone_number": "773-366-4901",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"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 Dec 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.