Organization Active NPI

Chicago Mindful Psychotherapy, Inc.

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1871863282
Registry record updated Jan 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149011529 Issued in IL
Legal business name
CHICAGO MINDFUL PSYCHOTHERAPY, INC.
Practice address
4737 N Clark St
Chicago, IL 60640-7758
Phone
(773) 368-9619
NPI assigned
Jan 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2012

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

Authorized official

Name
Georgia Jones, LCSW
Title
Owner
Phone
(773) 368-9619

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 149011529 IL Primary

Addresses

Primary practice location

4737 N Clark St
Chicago, IL 60640-7758

Mailing address

4737 N Clark St
Chicago, IL 60640-7758
Phone (773) 368-9619

National Provider Directory

National Provider Directory

Locations

53 W Jackson Blvd
Ste 709
Chicago, IL 60604
Phone (773) 454-1807

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": "1325548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325548800000",
    "number": "1871863282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4737 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407758",
            "telephone_number": "773-368-9619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4737 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407758",
            "telephone_number": "773-368-9619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO MINDFUL PSYCHOTHERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-03",
        "last_updated": "2012-01-03",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "GEORGIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-368-9619",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149011529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; 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.