BLUE WILLOW THERAPY LLC NPI 1417629353

NPI Information

NPI: 1417629353
Provider Name: BLUE WILLOW THERAPY, LLC
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
2343 W WINONA ST
CHICAGO, IL
ZIP 60625
Phone: (217) 691-2760
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BLUE WILLOW THERAPY, LLC is an adult mental health clinic center in Chicago, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. BLUE WILLOW THERAPY, LLC NPI is 1417629353. The provider is registered as an organization entity type.

The provider's business location address is:

2343 W WINONA ST
CHICAGO, IL
ZIP 60625-853
Phone: (217) 691-2760

The provider's authorized official is Taneka Taylor .
The authorized official title is Clinical Therapist and has the following contact phone number (217) 691-2760.

The enumeration date for this NPI number is 9/29/2021 and was last updated on 12/20/2021.

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	261QM0850X	Clinic/Center	Adult Mental Health			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: 11/14/2023

NPI Synchronization or Removal

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