NPIMap

Organization Active NPI

Prosper Mental Health Inc

  • Psychiatry Physician
  • Calumet Park, IL
National Provider Identifier
1760136238
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PROSPER MENTAL HEALTH INC
Practice address
1137 W 127TH St
Calumet Park, IL 60827-6537
Phone
(708) 620-7807
NPI assigned
Feb 3, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Authorized official

Name
Mrs. Stacey Davis, APRNNPI 1508454448
Title
President
Phone
(708) 620-7807

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
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

1137 W 127TH St
Calumet Park, IL 60827-6537

Mailing address

1137 W 127TH St
Calumet Park, IL 60827-6537
Phone (708) 620-7807

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": "1643846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643846400000",
    "number": "1760136238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1137 W 127TH ST",
            "city": "CALUMET PARK",
            "state": "IL",
            "postal_code": "608276537",
            "telephone_number": "708-620-7807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1137 W 127TH ST",
            "city": "CALUMET PARK",
            "state": "IL",
            "postal_code": "608276537",
            "telephone_number": "708-620-7807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPER MENTAL HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-03",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-620-7807",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calumet Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.