STATE OF MIND MENTAL HEALTH & CONSULTATION SERVICES P.C. (NPI# 1457685604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457685604 |
| Entity Type | Organization |
| Organization Name | STATE OF MIND MENTAL HEALTH & CONSULTATION SERVICES P.C. |
| Practice Address |
400 E 41st St Suite 101a Chicago IL 60653-3071 |
| Mailing Address |
17911 Los Angeles Ave Homewood IL 60430-1509 |
| Practice Telephone | 7732850804 |
| Practice Fax Number | 7732850804 |
| Mailing Telephone | 7087984510 |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2009-09-21 |
| Authorized Official Name | MS. LATANYA MARIE MCFIELD (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7738072144 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 180006065 | IL | Agencies |
| Street Address |
400 E 41ST ST SUITE 101A |
| City | CHICAGO |
| State | IL |
| Zip Code | 60653-3071 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821023714 | Rajesh T Iyengar | Family Medicine | 400 E 41st St, Suite 103, Chicago, IL 60653-3071 | 2006-07-11 |
| 1033396239 | Medical Specialist | Internal Medicine | 400 E 41st St, Chicago, IL 60653-3071 | 2008-01-30 |
| 1821206327 | Latanya Marie Mcfield | Psychologist | 400 E 41st St, Suite 101a, Chicago, IL 60653-3071 | 2007-05-18 |
| 1104995034 | Access Community Health Network | Clinic/Center | 400 E 41st St, Chicago, IL 60653-3071 | 2006-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881215804 | Pamela Ann Brazelton-sykes | Counselor | Pioneer Gardens Supportive Living, 3800 S King Dr, Chicago, IL 60653 | 2020-04-30 |
| 1962915439 | Pickup Transport Lllp | Non-emergency Medical Transport (VAN) | 4418 S. Oakenwald Ave, Chicago, IL 60653 | 2017-11-07 |
| 1245758309 | Qi Wellness LLC | Case Management | 525 E 46th Place, Chicago, IL 60653 | 2017-09-08 |
| 1598202897 | Fadesire O Ajuwon | Registered Nurse | 4218 S King Dr, 1n, Chicago, IL 60653 | 2017-01-24 |
| 1013464619 | Roundys Supermarkets Inc | Pharmacy | 3857 S Dr Martin Luther King Jr Dr, Chicago, IL 60653 | 2016-09-01 |
| 1417384793 | Griffin Orthodontics PC | Dentist | 1040 E 47th Street, Chicago, IL 60653 | 2013-10-02 |
| 1114350659 | Carita Dale Johnson | Pharmacist | 3753 S. Cottage Grove Ave, 104, Chicago, IL 60653 | 2013-08-20 |
| 1245677848 | Mercy Diagnostic and Treatment Center | Clinic/Center | 3755 S Cottage Grove, Chicago, IL 60653 | 2013-05-23 |
| 1952745937 | Mercy Community Pharmacy At Oakwood Shores | Pharmacy | 3753 S. Cottage Grove, Chicago, IL 60653 | 2013-04-22 |
| 1386952315 | Jami S Little | Developmental Therapist | 617 East 41st, Chicago, IL 60653 | 2010-09-24 |
| Find all providers in zip 60653 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336753896 | Counseling Kennedy Shenberg | Community/Behavioral Health | 5752 N Campbell Ave Apt 1, Chicago, IL 60659-5080 | 2020-09-02 |
| 1700498573 | Bobby E. Wright Comprehensive Behavioral Health Center, Inc. | Community/Behavioral Health | 5816 W Division St Fl 1, Chicago, IL 60651-1003 | 2020-08-21 |
| 1164030557 | Acorn & Oak Counseling Pllc | Community/Behavioral Health | 1333 W Devon Ave Ste 319, Chicago, IL 60660-1329 | 2020-07-21 |
| 1144848300 | Marathon Mindset Counseling LLC | Community/Behavioral Health | 1650 W Adams St Apt 304, Chicago, IL 60612-3209 | 2020-07-13 |
| 1417586678 | Invisions Behavioral Health LLC | Community/Behavioral Health | 8211 S Woodlawn Ave, Chicago, IL 60619-4519 | 2020-04-08 |
| 1871124784 | Nurture Therapy, LLC | Community/Behavioral Health | 3711 N Ravenswood Ave Ste 146, Chicago, IL 60613-5944 | 2020-01-29 |
| 1962032086 | Bucktown Therapy | Community/Behavioral Health | 1820 W Webster Ave Ste 200, Chicago, IL 60614-2934 | 2020-01-16 |
| 1770121436 | Guided Expressions LLC | Community/Behavioral Health | 6640 S University Ave Apt 2, Chicago, IL 60637-4320 | 2019-12-12 |
| 1063058279 | Y Not Families | Community/Behavioral Health | 6427 S Ashland Ave, Chicago, IL 60636-2716 | 2019-11-22 |
| 1073156196 | Black Tie Therapy | Community/Behavioral Health | 2232 N Wayne Ave Apt 1f, Chicago, IL 60614-8937 | 2019-10-21 |
| 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.