Organization Active NPI

Live Fully Therapy PLLC

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1932822319
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
LIVE FULLY THERAPY PLLC
Practice address
1435 W Wrightwood Ave
Chicago, IL 60614-0625
Phone
(312) 857-4868
NPI assigned
Sep 21, 2022
Last updated
Sep 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Authorized official

Name
Ashley Barrient, MED, LCPC, RD, LDNNPI 1780013227
Title
LCPC and Dietitian
Phone
(228) 547-5111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary
Registered Dietitian 133V00000X NU

Addresses

Primary practice location

1435 W Wrightwood Ave
Chicago, IL 60614-0625

Mailing address

1435 W Wrightwood Ave Apt 3
Chicago, IL 60614-0625
Phone (228) 547-5111

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663718400000",
    "number": "1932822319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 W WRIGHTWOOD AVE APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606140625",
            "telephone_number": "228-547-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 W WRIGHTWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606140625",
            "telephone_number": "312-857-4868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE FULLY THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A",
        "authorized_official_last_name": "BARRIENT",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "LCPC AND DIETITIAN",
        "authorized_official_telephone_number": "228-547-5111",
        "authorized_official_credential": "MED, LCPC, RD, LDN"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Sep 21, 2022; 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.