NPIMap

Organization Active NPI

Proactive Psychotherapy LLC

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1629453279
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.017752 Issued in IL
Legal business name
PROACTIVE PSYCHOTHERAPY LLC
Practice address
630 W Wrightwood Ave
5E
Chicago, IL 60614-6266
Phone
(847) 987-8679
NPI assigned
Jul 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Authorized official

Name
Victoria Krone, LCSW
Title
Founder
Phone
(847) 987-8679

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 149.017752 IL Primary

Addresses

Primary practice location

630 W Wrightwood Ave
5E
Chicago, IL 60614-6266

Mailing address

630 W Wrightwood Ave
5E
Chicago, IL 60614-6266
Phone (847) 987-8679

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479254400000",
    "number": "1629453279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W WRIGHTWOOD AVE",
            "address_2": "5E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606146266",
            "telephone_number": "847-987-8679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W WRIGHTWOOD AVE",
            "address_2": "5E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606146266",
            "telephone_number": "847-987-8679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-24",
        "last_updated": "2016-11-16",
        "status": "A",
        "authorized_official_last_name": "KRONE",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "847-987-8679",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

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