Individual provider Active NPI

Michelle Ahmed, MS, AMFT

  • Marriage & Family Therapist
  • Chicago, IL
National Provider Identifier
1639705114
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
208.000806 Issued in IL
Practice address
5100 N Ravenswood Ave Ste 219
Chicago, IL 60640-1710
Phone
(312) 912-1033
NPI assigned
Mar 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 208.000806 IL Primary

Addresses

Primary practice location

5100 N Ravenswood Ave Ste 219
Chicago, IL 60640-1710

Mailing address

6822 N Kolmar Ave
Lincolnwood, IL 60712-4701
Phone (312) 912-1033

Other practice location 1

2835 N Sheffield Ave Fl 5
Chicago, IL 60657-5081
Phone (312) 912-1033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
208.000806ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Food for Heart Therapy PLLC Marriage & Family Therapist PastSince Aug 28, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1584403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1639705114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6822 N KOLMAR AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607124701",
            "telephone_number": "312-912-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 N RAVENSWOOD AVE STE 219",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401710",
            "telephone_number": "312-912-1033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2835 N Sheffield Ave Fl 5",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606575081",
            "country_code": "US",
            "telephone_number": "312-912-1033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHMED",
        "first_name": "MICHELLE",
        "credential": "MS, AMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-17",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "208.000806",
            "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 Mar 17, 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.