SELF ASSEMBLED PSYCHOTHERAPY PLLC NPI 1356064208

NPI Information

  • NPI: 1356064208
  • Provider Name: SELF ASSEMBLED PSYCHOTHERAPY, PLLC
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Organization
  • Address: 5206 N LIND AVE
    CHICAGO, IL
    ZIP 60630
  • Phone: (608) 217-4711

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NPI Details

SELF ASSEMBLED PSYCHOTHERAPY, PLLC is a mental health counselor in Chicago, IL. SELF ASSEMBLED PSYCHOTHERAPY, PLLC NPI is 1356064208. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5206 N LIND AVE
CHICAGO, IL
ZIP 60630-436
Phone: (608) 217-4711

The provider's authorized official is Katherine Jellinek Aldag .
The authorized official title is Founder & Bilingual Psychotherapist and has the following contact phone number (608) 217-4711.

The enumeration date for this NPI number is 9/26/2022 and was last updated on 10/24/2022.

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
1101Y00000XCounselorNo
2101YP2500XCounselorProfessionalNo
31041C0700XSocial WorkerClinicalNo
4101YM0800XCounselorMental HealthYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11760098966OTHERILLINOISLICENSED PROFESSIONAL COUNSELOR

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: 11/21/2025

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