Wellness Path Therapy Center

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

WELLNESS PATH THERAPY CENTER

Practice address

1133 E 83Rd St Unit 172
Chicago, IL 60619-6400

Phone

(312) 305-1007

Fax

(773) 207-5335

NPI assigned

Oct 29, 2020

Organization subpart

No

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

Authorized official

Name

Ajibola Obajimi, LCPCNPI 1366936767

Title

Lead Therapist

Phone

(312) 305-1007

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ajibola A Obajimi, LCPC

  • Professional Counselor
  • Chicago, IL
  • NPI 1366936767
  NPD Authorized official

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620345600000",
    "number": "1720688591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 E 83RD ST UNIT 172",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606196400",
            "telephone_number": "312-305-1007",
            "fax_number": "773-207-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 E 83RD ST UNIT 172",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606196400",
            "telephone_number": "312-305-1007",
            "fax_number": "773-207-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS PATH THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-29",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A",
        "authorized_official_last_name": "OBAJIMI",
        "authorized_official_first_name": "AJIBOLA",
        "authorized_official_title_or_position": "LEAD THERAPIST",
        "authorized_official_telephone_number": "312-305-1007",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "LAPTOP",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1133 E 83rd St Unit 172",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606196400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; 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.