Active NPI
Assemblage Psychological Services, PLLC
- Clinical Psychologist
- Chicago, IL
National Provider Identifier
1417852971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Legal business name
- ASSEMBLAGE PSYCHOLOGICAL SERVICES, PLLC
- Practice address
- 3323 W Diversey Ave
Chicago, IL 60647-8582 - Phone
- (312) 248-3442
- NPI assigned
- Oct 13, 2026
- Last updated
- Oct 13, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Leslie K Poulos, PSYD
- Title
- Owner
- Phone
- (312) 248-3442
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | NU | Primary |
Addresses
Primary practice location
3323 W Diversey Ave
Chicago, IL 60647-8582
Mailing address
7230 Olcott Ave
Hammond, IN 46323-2044
Phone (312) 248-3442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1791849600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1791849600000",
"number": "1417852971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7230 OLCOTT AVE",
"city": "HAMMOND",
"state": "IN",
"postal_code": "463232044",
"telephone_number": "312-248-3442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3323 W DIVERSEY AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606478582",
"telephone_number": "312-248-3442"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ASSEMBLAGE PSYCHOLOGICAL SERVICES, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-10-13",
"last_updated": "2026-10-13",
"certification_date": "2026-10-13",
"status": "A",
"authorized_official_last_name": "POULOS",
"authorized_official_first_name": "LESLIE",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "312-248-3442",
"authorized_official_credential": "PSYD"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NU",
"license": null,
"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 Oct 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.