NPIMap

Organization Active NPI

Mosaic Therapy

  • Community/Behavioral Health Agency
  • Morton Grove, IL
National Provider Identifier
1366899668
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
16002 Issued in IL
Legal business name
MOSAIC THERAPY
Practice address
8300 Callie Ave
Morton Grove, IL 60053-3721
Phone
(312) 799-9351
NPI assigned
May 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Authorized official

Name
Mrs. Veronica Vyazovsky
Title
Executive Director
Phone
(312) 799-9351

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 16002 IL Primary

Addresses

Primary practice location

8300 Callie Ave
Morton Grove, IL 60053-3721

Mailing address

7925 Lincoln Ave
Skokie, IL 60077-3679
Phone (312) 799-9351

National Provider Directory

National Provider Directory
Tax ID family
Mosaic Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463443200000",
    "number": "1366899668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7925 LINCOLN AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773679",
            "telephone_number": "312-799-9351",
            "fax_number": "888-975-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 CALLIE AVE",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600533721",
            "telephone_number": "312-799-9351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSAIC THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-17",
        "last_updated": "2016-05-17",
        "status": "A",
        "authorized_official_last_name": "VYAZOVSKY",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "312-799-9351",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "16002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; 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.