NPIMap

Organization Active NPI

Center for Authentic Living

  • Mental Health Counselor
  • Park Ridge, IL
National Provider Identifier
1417318700
Registry record updated Mar 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1326241860 Issued in IL
Legal business name
CENTER FOR AUTHENTIC LIVING
Practice address
120 Main St
Suite 200
Park Ridge, IL 60068-4044
Phone
(847) 668-4859
NPI assigned
Mar 14, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2016

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

Authorized official

Name
Dr. Mari Richko, ND LCPC
Title
Owner
Phone
(847) 668-4869

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 1326241860 IL Primary

Addresses

Primary practice location

120 Main St
Suite 200
Park Ridge, IL 60068-4044

Mailing address

120 Main St
Suite 200
Park Ridge, IL 60068-4044
Phone (847) 668-4859

National Provider Directory

National Provider Directory
Tax ID family
Center for Authentic Living2 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.

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457913600000",
    "number": "1417318700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MAIN ST",
            "address_2": "SUITE 200",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684044",
            "telephone_number": "847-668-4859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MAIN ST",
            "address_2": "SUITE 200",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684044",
            "telephone_number": "847-668-4859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR AUTHENTIC LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-14",
        "last_updated": "2016-03-14",
        "status": "A",
        "authorized_official_last_name": "RICHKO",
        "authorized_official_first_name": "MARI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-668-4869",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ND LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "1326241860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.