Individual provider Active NPI

Katherine Leatha Hargadon, AMFT

  • Marriage & Family Therapist
  • Chicago, IL
National Provider Identifier
1336995406
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
208001180 Issued in IL
Practice address
5100 N Ravenswood Ave Ste 208
Chicago, IL 60640-1710
Phone
(312) 772-5030
NPI assigned
Apr 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 208001180 IL Primary

Addresses

Primary practice location

5100 N Ravenswood Ave Ste 208
Chicago, IL 60640-1710

Mailing address

1620 W Winona St # 2
Chicago, IL 60640-2708
Phone (916) 899-9801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
208001180ILMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1336995406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 W WINONA ST # 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402708",
            "telephone_number": "916-899-9801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 N RAVENSWOOD AVE STE 208",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401710",
            "telephone_number": "312-772-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGADON",
        "first_name": "KATHERINE",
        "middle_name": "LEATHA",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "208001180",
            "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 Apr 29, 2024; 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.