Taylor Ariel Pettway, MS

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

1136 S Delano CT W Ste B201
Chicago, IL 60605-3734

Phone

(773) 791-0469

NPI assigned

Aug 22, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Phoenix Clinic NFP

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1316632672
  NPD Authorized official
• The Phoenix Clinic NFP

  • Adult Mental Health Clinic/Center
  • Chicago, IL
  • NPI 1811783079
  NPD Authorized official
• Northside Center for Relationship Counseling

  • Adult Mental Health Clinic/Center
  • Chicago, IL
  • NPI 1316747538

  Marriage & Family Therapist

  NPD (past)

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1922589639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 N RAVENSWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 S DELANO CT W STE B201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053734",
            "telephone_number": "773-791-0469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5100 N Ravenswood Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606401710",
            "country_code": "US",
            "telephone_number": "773-791-0469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTWAY",
        "first_name": "TAYLOR",
        "middle_name": "ARIEL",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-22",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antoinette M Pettitt, DDS
• Wilbur P Pettitt Jr., DDS
• Ethan Pettiway, MPT
• Alexander Jonathan Petts
• Markia Lenise Pettway, DO
• Cynthia Louise Petty, APN
• Danielle Petty, PT, DPT
• Jan Petty, MD
• Kellie N Petty
• Mary Lou Petty, MSW LCSW

• Marriage & Family Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Marriage & Family Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.