Organization Active NPI

C2Act, LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Arlington Heights, IL
National Provider Identifier
1790054542
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
C2ACT, LLC
Practice address
3417 N Kennicott Ave Ste a
Arlington Heights, IL 60004-7824
Phone
(224) 210-6694
Fax
(224) 836-5174
NPI assigned
Dec 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Authorized official

Name
Marjorie Diaz Rodriguez, MANPI 1578879433
Title
Licensed Clinical Social Worker
Phone
(224) 210-6694

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Community/Behavioral Health Agency 251S00000X 149011093 IL
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

3417 N Kennicott Ave Ste a
Arlington Heights, IL 60004-7824

Mailing address

3417 N Kennicott Ave Ste a
Arlington Heights, IL 60004-7824
Phone (224) 210-6694

National Provider Directory

National Provider Directory

Locations

3417 N Kennicott Ave
Ste A
Arlington Heights, IL 60004
Phone (224) 210-6694

Practitioners & affiliated clinicians

Practitioners 2

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": "1324598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646092800000",
    "number": "1790054542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 N KENNICOTT AVE STE A",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600047824",
            "telephone_number": "224-210-6694",
            "fax_number": "224-836-5174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 N KENNICOTT AVE STE A",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600047824",
            "telephone_number": "224-210-6694",
            "fax_number": "224-836-5174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C2ACT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-23",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A",
        "authorized_official_last_name": "DIAZ RODRIGUEZ",
        "authorized_official_first_name": "MARJORIE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "224-210-6694",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "149011093",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.