OBSIDIAN HOLISTIC SERVICES LLC NPI 1801409008

NPI Information

  • NPI: 1801409008
  • Provider Name: OBSIDIAN HOLISTIC SERVICES, LLC
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 930 175TH ST STE 1E
    HOMEWOOD, IL
    ZIP 60430
  • Phone: (708) 462-2134

Map and Directions

Get Directions

NPI Details

OBSIDIAN HOLISTIC SERVICES, LLC is a mental health (including community mental health center) clinic center in Homewood, IL. OBSIDIAN HOLISTIC SERVICES, LLC NPI is 1801409008. The provider is registered as an organization entity type.

The provider's business location address is:

930 175TH ST STE 1E
HOMEWOOD, IL
ZIP 60430-078
Phone: (708) 462-2134

The provider's authorized official is Erica Washington .
The authorized official title is Director Of Operations and has the following contact phone number (708) 462-2134.

The enumeration date for this NPI number is 8/26/2020 and was last updated on 3/23/2023.

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
1261QM0850XClinic/CenterAdult Mental HealthNo
2261QM0855XClinic/CenterAdolescent and Children Mental HealthNo
3261QM1300XClinic/CenterMulti-SpecialtyNo
4101YA0400XCounselorAddiction (Substance Use Disorder)No
5101YM0800XCounselorMental HealthNo
6103K00000XBehavior AnalystNo
7104100000XSocial WorkerNo
81041C0700XSocial WorkerClinicalNo
9106H00000XMarriage & Family TherapistNo
10171100000XAcupuncturistNo
11261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)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: 11/21/2025

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.