Center for Modern Relationships PLLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

166.001024 Issued in IL

Legal business name

CENTER FOR MODERN RELATIONSHIPS PLLC

Practice address

1300 W Belmont Ave
Suite 303
Chicago, IL 60657-3200

Phone

(708) 557-3155

NPI assigned

Jan 4, 2017

Organization subpart

No

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

Authorized official

Name

Michelle Herzog, LMFTNPI 1700641768

Title

Owner/Clinical Director

Phone

(708) 557-3155

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Michelle Herzog, LMFT, CST

  • Marriage & Family Therapist
  • Chicago, IL
  • NPI 1700641768
  NPD Authorized official

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

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1669917324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W BELMONT AVE",
            "address_2": "SUITE 303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573200",
            "telephone_number": "708-557-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W BELMONT AVE",
            "address_2": "SUITE 303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573200",
            "telephone_number": "708-557-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR MODERN RELATIONSHIPS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-04",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "HERZOG",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "708-557-3155",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.001024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Marriage & Family Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.