Chicago Center for Conscious Living

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149011049 Issued in IL

Legal business name

CHICAGO CENTER FOR CONSCIOUS LIVING

Practice address

5100 N Ravenswood Ave
Suite 211
Chicago, IL 60640-1710

Phone

(773) 480-5297

NPI assigned

May 16, 2016

Organization subpart

No

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

Authorized official

Name

Meredith Cohn Srivastava, LCSW

Title

Psychotherapist

Phone

(773) 480-5297

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463356800000",
    "number": "1508213091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 N RAVENSWOOD AVE",
            "address_2": "SUITE 211",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401710",
            "telephone_number": "773-480-5297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 N RAVENSWOOD AVE",
            "address_2": "SUITE 211",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401710",
            "telephone_number": "773-480-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO CENTER FOR CONSCIOUS LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-16",
        "last_updated": "2016-05-16",
        "status": "A",
        "authorized_official_last_name": "SRIVASTAVA",
        "authorized_official_first_name": "MEREDITH",
        "authorized_official_middle_name": "COHN",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "773-480-5297",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149011049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.