Organization Active NPI

Gol Relational Center, PLLC

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1295371367
Registry record updated Dec 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
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

Updated by the provider on Dec 10, 2023

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

Authorized official

Name
Ms. Fateme Targol HasankhaniNPI 1720324197
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)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 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 Directory

Practitioners & 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.

Verify at the official NPI Registry.