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NORTH SHORE PSYCHOTHERAPY LLC NPI 1154814713


NPI Information

NPI: 1154814713
Provider Name: NORTH SHORE PSYCHOTHERAPY, LLC
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

CLIA Number: 14D2209640

Address:
2502 N CLARK ST
CHICAGO, IL
ZIP 60614
Phone: (847) 778-5533
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NORTH SHORE PSYCHOTHERAPY, LLC is a clinical psychologist in Chicago, IL. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. NORTH SHORE PSYCHOTHERAPY, LLC NPI is 1154814713. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2502 N CLARK ST
CHICAGO, IL
ZIP 60614-850
Phone: (847) 778-5533

The provider's authorized official is Jody K Rotblatt .
The authorized official title is Owner and has the following contact phone number (847) 323-8189.

The CLIA number assigned to this NPI record is 14D2209640 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/8/2018 and was last updated on 9/25/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinical149018766ILLINOISNo
2103TC0700XPsychologistClinical071008109ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11487872735OTHERILLINOISBCBS-IL
21982122412OTHERILLINOISBCBS-IL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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