Larkspur Counseling Collaborative, PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

LARKSPUR COUNSELING COLLABORATIVE, PLLC

Practice address

1950 W Summerdale Ave
Chicago, IL 60640-1039

Phone

(773) 510-4018

NPI assigned

Apr 12, 2024

Organization subpart

No

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

Authorized official

Name

Jancey Wickstrom, LCSWNPI 1467695148

Title

Manager

Phone

(773) 510-4018

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jancey Lee Wickstrom, MA, LCSW

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1467695148
  NPD Authorized official

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

{
    "created_epoch": "1712880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1992559389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 W SUMMERDALE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 W SUMMERDALE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401039",
            "telephone_number": "773-510-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARKSPUR COUNSELING COLLABORATIVE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-12",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "WICKSTROM",
        "authorized_official_first_name": "JANCEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-510-4018",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie A Larkin, OT
• Pamela J Larkin, LCPC
• Kesha Shontee Marie Larkins, LCPC
• Lavar D. Larks, DC
• Lavonda Larks
• Melissa Larmon, MSMFT
• Lauren Larocca, NP
• Samantha Rae Larocca, MA CCC-SLP
• Natasha Larose, MD
• Melfa Laroza

• Mental Health Clinic/Center (Including Community Mental Health Center) in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.