ANDERSONVILLE COUNSELING CENTER, LLC


Address: 5412 N Clark St, Suite 210, Chicago, IL 60640-1272
Phone: 8473314600

ANDERSONVILLE COUNSELING CENTER, LLC (NPI# 1568867398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1568867398
Entity Type Organization
Organization Name ANDERSONVILLE COUNSELING CENTER, LLC
Practice Address 5412 N Clark St
Suite 210
Chicago
IL 60640-1272
Mailing Address 5315 N Clark St
Ste 319
Chicago
IL 60640-2290
Practice Telephone 8473314600
Practice Fax Number 7734095590
Mailing Telephone 8473314600
Mailing Fax Number 7734095590
Enumeration Date 2014-10-22
Last Update Date 2014-10-22
Authorized Official Name DR. ROBERT T BAKER III (CHIEF PSYCHOLOGIST)
Authorized Official Telephone 8473314600
Authorized Official Credential PSY.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103T00000X Psychologist 071006239 IL Behavioral Health & Social Service Providers

Office Location

Street Address 5412 N CLARK ST
SUITE 210
City CHICAGO
State IL
Zip Code 60640-1272

Providers in the same location

NPI Name Taxonomy Address Enumeration
1609914654 S. Anne Redmond Counselor 5412 N Clark St, South Suite, Chicago, IL 60640-1223 2007-02-02
1922623362 Self Bound Counseling LLC Counselor 5412 N Clark St, Chicago, IL 60640-1223 2020-06-11
1881146314 Rachel Baker Counselor 5412 N Clark St, Chicago, IL 60640-1223 2016-11-01
1306280516 Robert Thomas Baker IIi Psychologist 5412 N Clark St, #210, Chicago, IL 60640-1223 2013-04-18
1689962151 Anthony P. Oltean Social Worker 5412 N Clark St, Chicago, IL 60640-1223 2011-07-18
1598095499 Diana L Campbell Social Worker 5412 N Clark St, Chicago, IL 60640-1223 2009-12-28
1487980470 Mary Ellen Boyte Naprapath 5412 N Clark St, Chicago, IL 60640-1223 2009-10-26

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1336754233 Rci (wrs), LLC. Clinic/Center 5221-23 North Broadway, Chicago, IL 60640 2020-09-09
1548871916 Borici Counseling LLC Counselor 4731 N Paulina St, Chicago, IL 60640 2020-08-11
1306319173 Gerardo Garcia Physician Assistant Medical Staff Office, Weiss Memorial Hospital, 4646 N Marine Drive, Chicago, IL 60640 2019-01-04
1386121283 Aea Optical Ventures, LLC Clinic/Center 4814 N Clark St, Chicago, IL 60640 2018-07-24
1023503885 Lauren Vassiliades Internal Medicine Weiss Memorial Hospital, Medical Education Dpt., 4646 N. Marine Drive, C Elevators, 7th Flr. # 7100, Chicago, IL 60640 2018-06-25
1477061620 Yesenia Vargas Nurse Practitioner 1025 W Sunnyside, Chicago, IL 60640 2018-01-22
1932622206 Jasleen Kaur Brar Internal Medicine 4646 N. Marine Dr., Chicago, IL 60640 2017-07-19
1750802849 Umer Mukhtar Internal Medicine 4646 N. Marine Dr. Med Ed Dept. C Elevators., Weiss Memorial Hospital. 7 Floor. #7100, Chicago, IL 60640 2017-06-29
1184144081 Ellie Navidson Registered Nurse 1015 W Lawrence, 2nd Floor, Chicago, IL 60640 2017-06-21
1962932558 Jennifer Stridh Marriage & Family Therapist 5125 N. Winthrop Ave, 1f, Chicago, IL 60640 2017-06-15
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Taxonomy Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Notes: Source: American Psychological Association [1/1/2007: modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1689275265 Susan Benjamin Feingold Psyd and Associates LLC Psychologist 1038 N Crosby St, Chicago, IL 60610-2404 2020-11-02
1013524818 Lincoln Park Psychology, Inc. Psychologist 644 W Webster Ave # B, Chicago, IL 60614-3710 2020-09-25
1962016386 Brittney Aubin Psychologist 2555 N Clark St Apt 201, Chicago, IL 60614-1722 2020-09-02
1235750860 Dia Anjali Mason Psychologist 1234 N Kedzie Ave, Chicago, IL 60651-2408 2020-05-05
1811532880 Emily Wolodiger Psychologist 1645 W Jackson Blvd Ste 302, Chicago, IL 60612-3227 2019-11-13
1518500099 Allow Wellness LLC Psychologist 233 E Wacker Dr Apt 3901, Chicago, IL 60601-5115 2019-10-28
1619510914 Keeshawna Brooks Psychologist 325 N Wells St Ofc 523, Chicago, IL 60654-7024 2019-10-20
1104468800 Emotion-focused Therapy Chicago, LLC Psychologist 230 E Ohio St Ste 405, Chicago, IL 60611-5288 2019-10-14
1124660022 Lynne Lieberman Psychologist 325 S Paulina St, Chicago, IL 60612-3206 2019-10-11
1003462821 Michael Marek Maka Psychologist 820 W. Jackson Blvd, Suite 515, Chicago, IL 60607 2019-08-16
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Competitor

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City CHICAGO
Zip Code 60640

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Dataset Information

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.

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