Compassionate Couch Chicago PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

COMPASSIONATE COUCH CHICAGO PLLC

Practice address

1200 N Ashland Ave Ste 500
PMB 6094
Chicago, IL 60622-8327

Phone

(515) 817-3828

NPI assigned

May 28, 2024

Organization subpart

No

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

Authorized official

Name

Ezza Melina Ahmad Mustaffa, MEDNPI 1669029542

Title

LCPC

Phone

(515) 817-3828

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ezza Melina Ahmad Mustaffa

  • Professional Counselor
  • Chicago, IL
  • NPI 1669029542
  NPD Authorized official

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1841030913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "878 N PAULINA ST APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225093",
            "telephone_number": "515-817-3828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N ASHLAND AVE STE 500",
            "address_2": "PMB 6094",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606228327",
            "telephone_number": "515-817-3828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASSIONATE COUCH CHICAGO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "AHMAD MUSTAFFA",
        "authorized_official_first_name": "EZZA MELINA",
        "authorized_official_title_or_position": "LCPC",
        "authorized_official_telephone_number": "515-817-3828",
        "authorized_official_credential": "MED"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.