Karl Southgate, PSY.D., L.P.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

178.012318 Issued in IL

Practice address

8 S Michigan Ave
Suite 2100
Chicago, IL 60603-3357

Phone

(312) 344-1081

NPI assigned

Oct 11, 2016

Last updated

Oct 11, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1396295572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5544 N WINTHROP AVE",
            "address_2": "APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401410",
            "telephone_number": "312-965-7379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 S MICHIGAN AVE",
            "address_2": "SUITE 2100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606033357",
            "telephone_number": "312-344-1081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHGATE",
        "first_name": "KARL",
        "name_prefix": "Dr.",
        "credential": "PSY.D., L.P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-11",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.012318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 11, 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.