Organization Active NPI

Lamont T Brown Taylor

Doing business as Full Advocate BHS

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1720262991
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-011481 Issued in IL
Legal business name
LAMONT T BROWN TAYLOR
Doing business as
Full Advocate BHS
Practice address
10540 S Western Ave
Suite 402
Chicago, IL 60643-2529
Phone
(773) 509-5055
Fax
(773) 509-5010
NPI assigned
Dec 24, 2007
Last updated
Oct 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Authorized official

Name
Dr. Lamont Theolonus Taylor, DSWNPI 1124041199
Title
License Clinical Social Worker
Phone
(773) 509-5055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 149-011481 IL
Mental Health Counselor 101YM0800X 149-011481 IL
Social Worker 104100000X 149-011481 IL
Clinical Social Worker 1041C0700X 149-011481 IL Primary

Addresses

Primary practice location

10540 S Western Ave
Suite 402
Chicago, IL 60643-2529

Mailing address

PO Box 490645
Chicago, IL 60649-0645
Phone (773) 509-5055

Other names 1

  • Full Advocate BHS Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477612800000",
    "number": "1720262991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490645",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606490645",
            "telephone_number": "773-509-5055",
            "fax_number": "773-509-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10540 S WESTERN AVE",
            "address_2": "SUITE 402",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606432529",
            "telephone_number": "773-509-5055",
            "fax_number": "773-509-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAMONT T BROWN TAYLOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-24",
        "last_updated": "2016-10-28",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "LAMONT",
        "authorized_official_middle_name": "THEOLONUS",
        "authorized_official_title_or_position": "LICENSE CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "773-509-5055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "149-011481",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "149-011481",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "149-011481",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-011481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Full Advocate BHS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 28, 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.