Chicago Youth Service Bureau

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

CHICAGO YOUTH SERVICE BUREAU

Practice address

1525 E 53Rd St
Chicago, IL 60615-4557

Phone

(773) 906-6690

NPI assigned

Apr 3, 2023

Organization subpart

No

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

Authorized official

Name

Jessica Petty

Title

LPC

Phone

(773) 906-6690

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687132800000",
    "number": "1841995644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 E 53RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E 53RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154557",
            "telephone_number": "773-906-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO YOUTH SERVICE BUREAU",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A",
        "authorized_official_last_name": "PETTY",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "LPC",
        "authorized_official_telephone_number": "773-906-6690"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chicago Women'S Health, LTD
• Chicago Women'S Health, Organization, LLC
• Chicago Women'S Healthcare, SC
• Chicago Womens Health Group
• Chicago Youth Centers
• Chicago-Barton, LLC
• Chicagoland Ad Medical Inc
• Chicagoland Chiropractic Health Center S C
• Chicagoland Cognitive Assessment Center, LLC
• Chicagoland Community Pediatric Cardiology SC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; 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.