Humboldt Park Counseling, PLLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

HUMBOLDT PARK COUNSELING, PLLC

Practice address

938 N California Ave
Commercial Unit
Chicago, IL 60622-1435

Phone

(312) 620-0408

NPI assigned

Sep 8, 2020

Last updated

Oct 15, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carolyn Sellers, LCSWNPI 1871025940

Title

Owner, Psychotherapist

Phone

(312) 620-0408

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, and the practitioner matching its NPPES authorized official.

• Carolyn Sellers, LCSW

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1871025940
  Authorized official Same address or phone

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634256000000",
    "number": "1750995650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3446 W HIRSCH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606512314",
            "telephone_number": "312-620-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "938 N CALIFORNIA AVE",
            "address_2": "COMMERCIAL UNIT",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221435",
            "telephone_number": "312-620-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMBOLDT PARK COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-08",
        "last_updated": "2021-10-15",
        "certification_date": "2021-09-30",
        "status": "A",
        "authorized_official_last_name": "SELLERS",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "OWNER, PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "312-620-0408",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.simplepractice.com",
            "affiliation": "N",
            "endpointDescription": "simple practice ehr",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "938 N California Ave",
            "address_2": "Commercial Unit",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606221435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Humberto Vergara MD & Associates SC
• Humboldt Behavioral Health Group
• Humboldt Community Dental PC (Sonrisa Family Dental)
• Humboldt Park Counseling, PLLC
• Humboldt Park Counseling, PLLC
• Humboldt Park Counseling, PLLC (Rogers Park Counseling, PLLC)
• Humboldt Park Health
• Humboldt Park Health
• Humboldt Park Health (Physician Specialty)
• Humboldt Park Health (Prohealth Medical Center)

• Adult Mental Health Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Adult Mental Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.