Ethos Psychological Services LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071008161 Issued in IL

Legal business name

ETHOS PSYCHOLOGICAL SERVICES LLC

Practice address

444 N Northwest Hwy Ste 375
Park Ridge, IL 60068-3271

Phone

(917) 403-4631

NPI assigned

Sep 15, 2017

Organization subpart

No

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

Authorized official

Name

Dr. John Eliot Leffel, PSYDNPI 1205146958

Title

Director

Phone

(917) 403-4631

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Eliot Leffel, PSY.D., L.C.P.

  • Clinical Psychologist
  • Skokie, IL
  • NPI 1205146958
  Medicare reassignment NPD Authorized official
• Brian Hanna, PSY.D.

  • Clinical Psychologist
  • Park Ridge, IL
  • NPI 1477729465
  NPD

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

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651536000000",
    "number": "1316466857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7903 LOWELL AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600763537",
            "telephone_number": "917-403-4631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 N NORTHWEST HWY STE 375",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600683271",
            "telephone_number": "917-403-4631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHOS PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-15",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A",
        "authorized_official_last_name": "LEFFEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ELIOT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "917-403-4631",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.