NPIMap

Organization Active NPI

Northside Center for Relationship Counseling

  • Marriage & Family Therapist
  • Chicago, IL
National Provider Identifier
1720341993
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
166.000557 Issued in IL
Legal business name
NORTHSIDE CENTER FOR RELATIONSHIP COUNSELING
Practice address
1770 W Berteau Ave
Suite 302a
Chicago, IL 60613-1849
Phone
(773) 791-0469
NPI assigned
Jun 21, 2012
Last updated
Jun 21, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Authorized official

Name
Mr. Josh Smith Hetherington, LMFT, LCPC
Title
Director
Phone
(773) 791-0469

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180.003937 IL
Marriage & Family Therapist 106H00000X 166.000557 IL Primary

Addresses

Primary practice location

1770 W Berteau Ave
Suite 302a
Chicago, IL 60613-1849

Mailing address

1770 W Berteau Ave
Suite 302a
Chicago, IL 60613-1849
Phone (773) 791-0469

National Provider Directory

National Provider Directory
Tax ID family
Northside Center for Relationship Counseling2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

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": "1340236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340236800000",
    "number": "1720341993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 W BERTEAU AVE",
            "address_2": "SUITE 302A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131849",
            "telephone_number": "773-791-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 W BERTEAU AVE",
            "address_2": "SUITE 302A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131849",
            "telephone_number": "773-791-0469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE CENTER FOR RELATIONSHIP COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-21",
        "last_updated": "2012-06-21",
        "status": "A",
        "authorized_official_last_name": "HETHERINGTON",
        "authorized_official_first_name": "JOSH",
        "authorized_official_middle_name": "SMITH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "773-791-0469",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMFT, LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.003937",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.000557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 21, 2012; 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.