Center on Halsted

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

CENTER ON HALSTED

Practice address

3656 N Halsted St
Chicago, IL 60613-4316

Phone

(773) 472-6469

Fax

(773) 472-6643

NPI assigned

May 3, 2006

Organization subpart

No

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

Authorized official

Name

Modesto Valle

Title

Chief Executive Officer

Phone

(773) 472-6469

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Horizons Community Services Inc Former legal business name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ing Erik Swenson, LCSW, CRADC

  • Social Worker
  • Chicago, IL
  • NPI 1063680650
  Medicare reassignment
• Troy Eldon Gibson Jr., M.A., LCPC

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1649715962
  NPD
• Hector L Torres, PSYD

  • Psychologist
  • Chicago, IL
  • NPI 1346333713
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445385600000",
    "number": "1508824244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3656 N HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606134316",
            "telephone_number": "773-472-6469",
            "fax_number": "773-472-6643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3656 N HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606134316",
            "telephone_number": "773-472-6469",
            "fax_number": "773-472-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER ON HALSTED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2015-10-21",
        "status": "A",
        "authorized_official_last_name": "VALLE",
        "authorized_official_first_name": "MODESTO",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "773-472-6469"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01634461",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Horizons Community Services Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Center Home for Hispanic Elderly, LLC (Center Home for Hispanic Elderly)
• Center of Balance, PC
• Shoshana Margalit Center, DMD
• Centered Healing Therapy PLLC
• Centered Holistic, LLC (Centered Holistic Health)
• Centered Mind Psychotherapy, PLLC
• Centered Path Therapy PLLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.