DPS Therapy Group LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

DPS THERAPY GROUP LLC

Practice address

3245 Grove Ave Berwyn, Il 60402 Suite 103
Berwyn, IL 60402

Phone

(708) 955-1522

NPI assigned

Dec 30, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Denise Sandoval, LCPC

Title

Director/LCPC

Phone

(708) 955-1522

Specialties & licenses 3

Addresses

Other names 1

• DPS Therapy Group LLC Former legal business name

Electronic endpoints 1

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609286400000",
    "number": "1609463157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 GROVE AVE, SUITE 103",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "60402",
            "telephone_number": "708-955-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 GROVE AVE BERWYN, IL 60402 SUITE 103",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "60402",
            "telephone_number": "708-955-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DPS THERAPY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-30",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-21",
        "status": "A",
        "authorized_official_last_name": "SANDOVAL",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "DIRECTOR/LCPC",
        "authorized_official_telephone_number": "708-955-1522",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "denise@pedrozasandovaltherapy.com",
            "affiliation": "N",
            "address_1": "3245 Grove Ave Berwyn, IL 60402 Suite 103",
            "city": "Berwyn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "DPS Therapy Group LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; 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.