Chicago Bodymind Wellness Studio, LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

CHICAGO BODYMIND WELLNESS STUDIO, LLC

Practice address

3525 W Peterson Ave Ste 605
Chicago, IL 60659-3318

Phone

(872) 216-7797

NPI assigned

Jan 15, 2017

Organization subpart

No

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

Authorized official

Name

Francine Kelley, LCPC

Title

Co-Owner

Phone

(872) 216-7797

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1484438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484438400000",
    "number": "1871039826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 W PETERSON AVE STE 605",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 W PETERSON AVE STE 605",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593318",
            "telephone_number": "872-216-7797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO BODYMIND WELLNESS STUDIO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-15",
        "last_updated": "2017-01-15",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "FRANCINE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "872-216-7797",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Chicago, IL
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• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2017; 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.