1164814174 NPI number — THE CHICAGO SCHOOL OF PROFESSIONAL PSYCHOLOGY COUNSELING CENTERS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164814174 NPI number — THE CHICAGO SCHOOL OF PROFESSIONAL PSYCHOLOGY COUNSELING CENTERS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE CHICAGO SCHOOL OF PROFESSIONAL PSYCHOLOGY COUNSELING CENTERS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164814174
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/27/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1990 WESTWOOD BLVD
Provider Second Line Business Mailing Address:
SUITE 330
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90025-4650
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-481-5900
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1990 WESTWOOD BLVD
Provider Second Line Business Practice Location Address:
SUITE 330
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90025-4650
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-481-5900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/27/2015

Additional Information

Authorized Official

Authorized Official Last Name:
BAKER
Authorized Official First Name:
DAUN
Authorized Official Middle Name:
Authorized Official Title or Position:
AVP TRAINING AND LICENSURE AFFAIRS
Authorized Official Telephone Number:
310-481-5900

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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