Brookhaven Counseling Group, LLC (NPI# 1972199099) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider Identifier (NPI) | 1972199099 |
Entity Type | Organization |
Organization Name | BROOKHAVEN COUNSELING GROUP, LLC |
Practice Address |
2209 W Winona St Unit 2 Chicago IL 60625-1831 |
Practice Telephone | 8476520902 |
Mailing Address |
2209 W Winona St Unit 2 Chicago IL 60625-1831 |
Mailing Telephone | 8476520902 |
Authorized Official Name | Meredyth Brook (CEO AND LEAD THERAPIST) |
Authorized Official Telephone | 4765200902 |
Authorized Official Credential | LCPC |
Organization Subpart | No, this organization is not a Subpart |
Enumeration Date | 2020-12-13 |
Last Update Date | 2020-12-13 |
Primary | Taxonomy | Classification | Taxonomy Group | License Number | State |
---|---|---|---|---|---|
No | 101YM0800X | Counselor · Mental Health | Behavioral Health & Social Service Providers | ||
Yes | 261QM0850X | Clinic/Center · Adult Mental Health | Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Brookhaven Counseling Group | Other Name - Individual/Organization |
N/A | Other Name - Individual/Organization |
Taxonomy Code | 261QM0850X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Adult Mental Health |
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
Notes: [7/1/2003: new] |
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Find all providers in CHICAGO |
Street Address |
2209 W WINONA ST UNIT 2 |
City | CHICAGO |
State | IL |
Zip Code | 60625-1831 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407560287 | Ron Medina | 5140 N California Ave, Chicago, IL 60625-3645 | 2023-01-06 | |
1790499580 | Dhollie Lyn Dayao Quiamco | 5140 N California Ave, Chicago, IL 60625-3645 | 2023-01-06 | |
1578276309 | Jared Seigal | 4831 N Hoyne Ave # 2, Chicago, IL 60625-1407 | 2022-12-26 | |
1033821012 | Megan Trinter | 5259 N Sawyer Ave, Chicago, IL 60625-4715 | 2022-12-21 | |
1982316691 | Alexander George Freidinger | 4503 N Rockwell St Apt 3, Chicago, IL 60625-9301 | 2022-12-14 | |
1427767623 | Anya Ravitz | 2022 W Berwyn Ave Apt 3b, Chicago, IL 60625-1135 | 2022-11-16 | |
1780392332 | Arab American Community Center Home Service Agency | 5352 N Lincoln Ave, Chicago, IL 60625-2316 | 2022-11-14 | |
1639887847 | Porcia Seals | 5215 N California Ave Fl 7, Chicago, IL 60625-7014 | 2022-11-08 | |
1235846965 | Katherine Fearon | 4943 N Whipple St Apt 1n, Chicago, IL 60625-4132 | 2022-11-02 | |
1083321202 | Safia Fahad | 2740 W Foster Ave Ste 105, Chicago, IL 60625-3547 | 2022-10-28 | |
Find all providers in zip 60625 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.