Associated Behavioral Therapeutics Inc

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

ASSOCIATED BEHAVIORAL THERAPEUTICS INC

Practice address

4835 W Irving Park Rd
Chicago, IL 60641-2719

Phone

(773) 777-7413

Fax

(773) 777-7416

NPI assigned

Jul 22, 2006

Organization subpart

No

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

Authorized official

Name

Fred T Waltzer, LCSWNPI 1306897087

Title

President

Phone

(773) 777-7413

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Fred T Waltzer, LCSW

  • Clinical Social Worker
  • Lincolnwood, IL
  • NPI 1306897087
  NPD (past) Authorized official
• Richenel Samuel Ellecom, PSY.D; DR.P.H

  • Registered Dietitian
  • Willow Brook, IL
  • NPI 1063406569
  NPD (past)
• Sherrie Cecile Godbolt, M.D.

  • Psychiatry Physician
  • South Holland, IL
  • NPI 1114027828
  NPD (past)

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1609897974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4835 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412719",
            "telephone_number": "773-777-7413",
            "fax_number": "773-777-7416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4835 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412719",
            "telephone_number": "773-777-7413",
            "fax_number": "773-777-7416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED BEHAVIORAL THERAPEUTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "WALTZER",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-777-7413",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.