Generative Chaos

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

GENERATIVE CHAOS

Practice address

1518 N Cleveland Ave # 1
Chicago, IL 60610-1110

Phone

(773) 570-0498

NPI assigned

Jul 7, 2022

Organization subpart

No

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

Authorized official

Name

Theodora Cunningham, LCPCNPI 1295409217

Title

Owner and Operator

Phone

(773) 570-0498

Specialties & licenses 2

Addresses

Practitioners 1

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

• Theodora Cunningham

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1295409217
  NPD Authorized official

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657152000000",
    "number": "1346973278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 N CLEVELAND AVE # 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606101110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 N CLEVELAND AVE # 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606101110",
            "telephone_number": "773-570-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERATIVE CHAOS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "CUNNINGHAM",
        "authorized_official_first_name": "THEODORA",
        "authorized_official_title_or_position": "OWNER AND OPERATOR",
        "authorized_official_telephone_number": "773-570-0498",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.