Wise Behavioral Health Services LTD

Primary specialty

Group Psychotherapy PsychologistTaxonomy code 103TP2701X

Legal business name

WISE BEHAVIORAL HEALTH SERVICES LTD

Practice address

9012 S Crandon Ave
Chicago, IL 60617-3807

Phone

(773) 375-8741

Fax

(773) 375-8748

NPI assigned

Jan 8, 2008

Last updated

Jan 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Charles Tripp

Title

Administrator

Phone

(773) 510-6165

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199750400000",
    "number": "1710162862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9012 S CRANDON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606173807",
            "telephone_number": "773-375-8741",
            "fax_number": "773-375-8748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9012 S CRANDON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606173807",
            "telephone_number": "773-375-8741",
            "fax_number": "773-375-8748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE BEHAVIORAL HEALTH SERVICES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2008-01-08",
        "status": "A",
        "authorized_official_last_name": "TRIPP",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "773-510-6165",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; 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.