Chicago Therapy Working Group, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CHICAGO THERAPY WORKING GROUP, LLC

Practice address

4157 W Fletcher St
Chicago, IL 60641-5432

Phone

(312) 554-5425

NPI assigned

Oct 6, 2022

Organization subpart

No

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

Authorized official

Name

David Kullgren, MA, LCPCNPI 1780176909

Title

Owner

Phone

(312) 622-7115

Specialties & licenses 1

Addresses

Practitioners 2

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

• David T Kullgren

  • Mental Health Counselor
  • Elk Grove Village, IL
  • NPI 1780176909
  NPD (past) Authorized official
• Nathan Robbel

  • Counseling Psychologist
  • Chicago, IL
  • NPI 1972228328
  NPD

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

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1336864826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4157 W FLETCHER ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606415432",
            "telephone_number": "312-554-5425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4157 W FLETCHER ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606415432",
            "telephone_number": "312-554-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO THERAPY WORKING GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-06",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A",
        "authorized_official_last_name": "KULLGREN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-622-7115",
        "authorized_official_credential": "MA, LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chicago Top Physical Therapy Inc
• Chicago Treatment & Counseling Center #1
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• Chicago Treatment and Counseling Centers,Inc

• Mental Health Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.