Park Bench Psychotherapy, Inc.

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

PARK BENCH PSYCHOTHERAPY, INC.

Practice address

155 N Michigan Ave Ste 500F
Chicago, IL 60601-7511

Phone

(630) 640-9580

NPI assigned

May 8, 2019

Organization subpart

No

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

Authorized official

Name

Adam Lencioni

Title

Owner

Phone

(630) 640-9580

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1557273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557273600000",
    "number": "1700441458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1647 N ARTESIAN AVE UNIT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475308",
            "telephone_number": "630-640-9580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N MICHIGAN AVE STE 500F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017511",
            "telephone_number": "630-640-9580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK BENCH PSYCHOTHERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-08",
        "last_updated": "2019-05-08",
        "status": "A",
        "authorized_official_last_name": "LENCIONI",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-640-9580"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; 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.