NPI 1285036491 · live from the CMS NPI Registry
Breathe
Counselor, Professional in Orland Park, IL. National Provider Identifier 1285036491, active.
NPI record
| NPI | 1285036491 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Counselor, Professional 101YP2500X |
| Practice location | 15255 S 94th Ave, Orland Park, IL 60462 |
| Practice phone | 847-461-8718 |
| Mailing address | 329 W 102nd Pl, Chicago, IL 60628 |
| Enumerated | September 18, 2014 |
| Last updated | April 19, 2016 |
| Authorized official | Winifred Bradshaw, Director |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor | 101Y00000X | 180008522 (IL) |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | — |
| Counselor, Mental Health | 101YM0800X | 180008522 (IL) |
| Psychoanalyst | 102L00000X | 180008522 (IL) |
| Marriage & Family Therapist | 106H00000X | — |
| Case Management | 251B00000X | — |
| Community/Behavioral Health | 251S00000X | — |
| Preferred Provider Organization | 305R00000X | — |
| Psychiatric Unit | 273R00000X | — |
| Counselor, Professional primary | 101YP2500X | 180.008522 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.