Nourish Psychotherapy LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.007420 Issued in IL

Legal business name

NOURISH PSYCHOTHERAPY LLC

Practice address

5225 Old Orchard Rd Ste 29
Skokie, IL 60077-1027

Phone

(773) 403-2374

NPI assigned

Sep 4, 2018

Last updated

Sep 4, 2018By 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

Linnet Mendez, LCPCNPI 1699094250

Title

Practice Manager

Phone

(773) 403-2374

Specialties & licenses 3

Addresses

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.

• Linnet Mendez, LCPC

  • Professional Counselor
  • Skokie, IL
  • NPI 1699094250
  NPD Authorized official

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

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536019200000",
    "number": "1770065088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 OLD ORCHARD RD STE 29",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771027",
            "telephone_number": "773-403-2374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 OLD ORCHARD RD STE 29",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771027",
            "telephone_number": "773-403-2374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOURISH PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-04",
        "last_updated": "2018-09-04",
        "status": "A",
        "authorized_official_last_name": "MENDEZ",
        "authorized_official_first_name": "LINNET",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "773-403-2374",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.007420",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018995",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.013079",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; 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.