Fateme Targol Hasankhani, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

208.000567 Issued in IL

Practice address

4611 N Ravenswood Ave Ste 205
Chicago, IL 60640-7577

Phone

(773) 366-4901

NPI assigned

Dec 12, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Gol Relational Center, PLLC

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1295371367
  NPD Authorized official

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

{
    "created_epoch": "1355270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702771200000",
    "number": "1720324197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 N RAVENSWOOD AVE STE 205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407577",
            "telephone_number": "773-366-4901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 N RAVENSWOOD AVE STE 205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407577",
            "telephone_number": "773-366-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASANKHANI",
        "first_name": "FATEME",
        "middle_name": "TARGOL",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-12",
        "last_updated": "2023-12-17",
        "certification_date": "2023-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "208.000567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Uzma Naveen Hasan, M.D.
• Yasmin Hasan
• Zahid Aleem Hasan, MD
• Zainab Hasan
• Zeba M Hasan, M.D.
• Kristen Hasbargen
• Kevin Hascher
• Hase Zahn Inc.
• Abid Abdul Haseeb
• Susan L Hasegawa, M.D.

• 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 Dec 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.