Organization Active NPI

Center for Behavioral Health & Wellness, LLC

  • Clinical Psychologist
  • Park Ridge, IL
National Provider Identifier
1730201971
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
CENTER FOR BEHAVIORAL HEALTH & WELLNESS, LLC
Practice address
1440 Renaissance Dr
Suite 200
Park Ridge, IL 60068-1356
Phone
(847) 296-3484
NPI assigned
Apr 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ritu Devendra Trivedi-Purohit, PSYD.NPI 1093896169
Title
Licensed Clinical Psychologist
Phone
(847) 296-3484

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X IL Primary

Addresses

Primary practice location

1440 Renaissance Dr
Suite 200
Park Ridge, IL 60068-1356

Mailing address

549 Ivory LN
Bartlett, IL 60103-1230
Phone (630) 540-9495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070606000697 IL Part B Supplier - Clinic/Group Practice 3779681259 Receives reassigned benefits from 1 practitioner
Practice locations: Park Ridge, IL

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.

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730201971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "549 IVORY LN",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601031230",
            "telephone_number": "630-540-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 RENAISSANCE DR",
            "address_2": "SUITE 200",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681356",
            "telephone_number": "847-296-3484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR BEHAVIORAL HEALTH & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TRIVEDI-PUROHIT",
        "authorized_official_first_name": "RITU",
        "authorized_official_middle_name": "DEVENDRA",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "847-296-3484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.