FAMILY ADOLESCENT CHILD TREATMENT SERVICE LLC (NPI# 1578839700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578839700 |
| Entity Type | Organization |
| Organization Name | FAMILY ADOLESCENT CHILD TREATMENT SERVICE LLC |
| Practice Address |
4801 W Peterson Ave 401 Chicago IL 60646-5713 |
| Practice Telephone | 7732822322 |
| Practice Fax Number | 7732822853 |
| Mailing Telephone | 7732822322 |
| Mailing Fax Number | 7732822853 |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2012-04-02 |
| Authorized Official Name | DR. KATHERINE MARY BOHO (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 7732822322 |
| Authorized Official Credential | PSY.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 071004665 | IL | Behavioral Health & Social Service Providers |
| Street Address |
4801 W PETERSON AVE 401 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60646-5713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588667315 | Barry M Leavitt | Psychologist | 4801 W Peterson Ave, Ste 525, Chicago, IL 60646 | 2005-05-24 |
| 1790229441 | Valerie Deutsch | Behavioral Analyst | 4801 W Peterson Ave, Suite 512, Chicago, IL 60646-5713 | 2016-12-15 |
| 1730623729 | A Dragonfly Mind, LLC | Clinical Neuropsychologist | 4801 W Peterson Ave, Suite 301, Chicago, IL 60646-5726 | 2016-12-09 |
| 1760938260 | Catherine Bogacki | Social Worker | 4801 W Peterson Ave, Suite 308, Chicago, IL 60646-5713 | 2016-08-25 |
| 1841662434 | Paul Robert Muhr | Dentist | 4801 W Peterson Ave, Suite 407, Chicago, IL 60646-5713 | 2015-10-22 |
| 1548631245 | Amy Derusha | Behavioral Analyst | 4801 W Peterson Ave, 512, Chicago, IL 60646-5713 | 2015-10-07 |
| 1063818813 | Amalia Pepek | Nurse Practitioner | 4801 W Peterson Ave, Suite 506, Chicago, IL 60646-5713 | 2014-11-06 |
| 1689089286 | Roxanne Gayle | Behavioral Analyst | 4801 W Peterson Ave, #512, Chicago, IL 60646-5713 | 2014-06-23 |
| 1982018461 | Superior Rehab Center LLC | Physical Therapist | 4801 W Peterson Ave, 615, Chicago, IL 60646-5713 | 2014-06-12 |
| 1720415367 | Frank J Gutierrez | Counselor | 4801 W Peterson Ave, Suite 403, Chicago, IL 60646 | 2013-09-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801312087 | Manal Ibrahim | Dentist | 6228 N Keystone Ave, Chicago, IL 60646 | 2017-08-18 |
| 1750820742 | Kaitlin O'brien | Student in an Organized Health Care Education/Training Program | 5801 N Pulaski, Chicago, IL 60646 | 2017-02-23 |
| 1659810646 | Sofia Trani | Student in an Organized Health Care Education/Training Program | 5801 N. Pulaski Rd, Chicago, IL 60646 | 2017-02-23 |
| 1487191151 | Ronald E. Rysztogi | Naprapath | 5704 N. Austin, Chicago, IL 60646 | 2017-01-19 |
| 1417403148 | Joyful Dental Care | Clinic/Center | 6314 N. Cicero Avenue, Chicago, IL 60646 | 2016-09-01 |
| 1164889754 | Physicians At Call | Family Medicine | 5901 N. Cicero Ave, Ste 207, Chicago, IL 60646 | 2016-01-27 |
| 1245610617 | Arlett Payne | Physician Assistant | 5906 N Milwaukee, Chicago, IL 60646 | 2015-06-01 |
| 1811375843 | North River Mental Health Center | Community/Behavioral Health | 5801 North Pulaski Road, Chicago, IL 60646 | 2015-05-11 |
| 1003157298 | Family Choice Home Health | Homemaker | 5933 N Milwaukee Avenue, Chicago, IL 60646 | 2013-03-13 |
| 1235479593 | Antonina Skapars Trinkuns | Psychiatry & Neurology | 6404 N. Tahoma Ave., Chicago, IL 60646 | 2013-02-25 |
| Find all providers in zip 60646 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| 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] |
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| 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 |
| 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.