AGAVE STUDIO LLC NPI 1023427861

NPI Information

NPI: 1023427861
Provider Name: AGAVE STUDIO, LLC
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
2950 W CHICAGO AVE
SUITE 202
CHICAGO, IL
ZIP 60622
Phone: (618) 444-8801
Get Directions

AGAVE STUDIO, LLC is a professional counselor in Chicago, IL. AGAVE STUDIO, LLC NPI is 1023427861. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2950 W CHICAGO AVE
SUITE 202
CHICAGO, IL
ZIP 60622-375
Phone: (618) 444-8801

The provider's authorized official is Amanda G Bull .
The authorized official title is Billing Director, Staff Therapist and has the following contact phone number (618) 444-8801.

The enumeration date for this NPI number is 8/6/2014 and was last updated on 8/12/2014.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TC0700X	Psychologist	Clinical	071.008116	ILLINOIS	No
2	101YP2500X	Counselor	Professional	180008030	ILLINOIS	Yes

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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »