DEPAUL FAMILY & COMMUNITY SERVICES (NPI# 1083759534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083759534 |
| Entity Type | Organization |
| Organization Name | DEPAUL FAMILY & COMMUNITY SERVICES |
| Other Organization Name | DEPAUL UNIVERSITY COMMUNITY MENTAL HEALTH CENTER |
| Practice Address |
2219 N Kenmore Ave Room 300 Chicago IL 60614-3504 |
| Practice Telephone | 7733257780 |
| Mailing Telephone | 7733257780 |
| Mailing Fax Number | 7733257781 |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2014-09-23 |
| Authorized Official Name | ORSON A. MORRISON (DIRECTOR) |
| Authorized Official Telephone | 7733257780 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | DEPAUL UNIVERSITY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| DePaul University Community Mental Health Center | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285802025 | Depaul Family & Community Services | Clinic/Center | 811 W Evergreen Ave, 102a, Chicago, IL 60622-2682 | 2008-02-14 |
| 1629246467 | Depaul Family & Community Services | Clinic/Center | 2156 W Wellington Ave, Chicago, IL 60618-8156 | 2008-02-14 |
| Street Address |
2219 N KENMORE AVE ROOM 300 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60614-3504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841740974 | Silvia Henriquez Gerken | Psychologist | 2219 N Kenmore Ave, Suite 300, Chicago, IL 60614-3504 | 2016-10-13 |
| 1912319484 | Laura Benedict Pettineo | Psychologist | 2219 N Kenmore Ave, Suite 300, Chicago, IL 60614-3504 | 2014-06-02 |
| 1417297722 | Eva L. Johnson | Social Worker | 2219 N Kenmore Ave, Suite 300, Chicago, IL 60614-3504 | 2013-02-22 |
| 1740419381 | Thara Nagarajan | Psychologist | 2219 N Kenmore Ave, Chicago, IL 60614-3504 | 2009-07-02 |
| 1750504239 | Trina M Davis | Psychologist | 2219 N Kenmore Ave, Suite 300, Chicago, IL 60614-3504 | 2007-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487266516 | Taylor Connington | Pharmacist | 843 W Armitage Ave, Chicago, IL 60614 | 2020-08-19 |
| 1356975692 | Amarilis Diaz | Social Worker | Terry Hefter Associates, LLC, 1731 N. Marcey Suite 535, Chicago, IL 60614 | 2020-02-25 |
| 1457902975 | Michele Waggoner | Physical Therapist | 2515 N. Clark St, Chicago, IL 60614 | 2019-09-25 |
| 1669031936 | Justin Pomeroy | Acupuncturist | 1350 W. Schubert Ave., Chicago, IL 60614 | 2019-06-11 |
| 1801451547 | Amanda Harris | Counselor | 2451 N Lincoln Ave # 206, Chicago, IL 60614 | 2019-05-08 |
| 1780164574 | Danielle Trokey | Psychiatry & Neurology | 2515 N Clark St Ste 801, Chicago, IL 60614 | 2018-08-21 |
| 1841707353 | Madison Counseling Solutions LLC | Social Worker | 2502 N. Clark St., Chicago, IL 60614 | 2018-01-05 |
| 1386154011 | Allison Cooper Boyan | Occupational Therapist | 1640 N. Wells St., Unit 103, Chicago, IL 60614 | 2017-10-09 |
| 1245759653 | Eileen Davidson Siegel | Physician Assistant | 2073 N. Clybourn Ave., Chicago, IL 60614 | 2017-09-18 |
| 1447779814 | Elizabeth Hobart | Psychologist | 1800 W. Diversey Pkwy, Unit H, Chicago, IL 60614 | 2017-09-16 |
| Find all providers in zip 60614 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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|---|---|---|---|---|
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| 1144827320 | Envision Unlimited | Clinic/Center | 4919 N Clark St, Chicago, IL 60640-3514 | 2020-10-01 |
| 1194322370 | Envision Unlimited | Clinic/Center | 4911 S Hoyne Ave, Chicago, IL 60609-4721 | 2020-10-01 |
| 1144837055 | Totality. Therapies LLC | Clinic/Center | 2027 W Division St Ste 157, Chicago, IL 60622-9024 | 2020-09-24 |
| 1790391373 | Luminary Solutions, LLC | Clinic/Center | 3166 N Lincoln Ave Ste 305, Chicago, IL 60657-3119 | 2020-09-19 |
| 1114533924 | A Safe Haven, L.L.C. | Clinic/Center | 600 S Wabash Ave, Chicago, IL 60605-1808 | 2020-09-17 |
| 1235745142 | A Safe Haven, L.L.C. | Clinic/Center | 7355 N Damen Ave, Chicago, IL 60645-2311 | 2020-09-17 |
| 1386250199 | A Safe Haven, L.L.C. | Clinic/Center | 7342-46 S Kingston, Chicago, IL 60649 | 2020-09-17 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.