Basic Information
| Provider Information | |||||||||
| NPI: | 1447789516 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADVANCED PSYCHOTHERAPY SOLUTIONS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7360 N LINCOLN AVE STE 110 | ||||||||
| Address2: | |||||||||
| City: | LINCOLNWOOD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 607121705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8479721824 | ||||||||
| FaxNumber: | 8479838438 | ||||||||
| Practice Location | |||||||||
| Address1: | 7360 N LINCOLN AVE STE 110 | ||||||||
| Address2: | |||||||||
| City: | LINCOLNWOOD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 607121705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8479721824 | ||||||||
| FaxNumber: | 8479838438 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | SMITH | ||||||||
| AuthorizedOfficialFirstName: | SUSIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | BUSINESS OPERATIONS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8479721824 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TP2701X | 149015268 | IL | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Group Psychotherapy |
No ID Information.