Humboldt Behavioral Health Group

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071008046 Issued in IL

Legal business name

HUMBOLDT BEHAVIORAL HEALTH GROUP

Practice address

3317 W Le Moyne St
Chicago, IL 60651-2452

Phone

(312) 659-0020

NPI assigned

Aug 24, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Jason E Lahood, PSY.D.

Title

Director of Clinical Services

Phone

(312) 659-0020

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440374400000",
    "number": "1609243856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3317 W LE MOYNE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606512452",
            "telephone_number": "312-659-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3317 W LE MOYNE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606512452",
            "telephone_number": "312-659-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMBOLDT BEHAVIORAL HEALTH GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-24",
        "last_updated": "2015-08-24",
        "status": "A",
        "authorized_official_last_name": "LAHOOD",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL SERVICES",
        "authorized_official_telephone_number": "312-659-0020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008046",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IL",
            "license": "071008046",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaheen A Humayun, MD
• Wasay Humayun, M.D.
• Youshay Humayun, M.D.
• Michelle Humbert, LMSW
• Humberto Vergara MD & Associates SC
• Humboldt Community Dental PC (Sonrisa Family Dental)
• Humboldt Park Counseling, PLLC
• Humboldt Park Counseling, PLLC
• Humboldt Park Counseling, PLLC
• Humboldt Park Counseling, PLLC (Rogers Park Counseling, PLLC)

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; 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.