LINCOLN PARK PSYCHOLOGY, INC.


Address: 644 W Webster Ave # B, Chicago, IL 60614-3710
Phone: 7739913016

LINCOLN PARK PSYCHOLOGY, INC. (NPI# 1013524818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1013524818
Entity Type Organization
Organization Name LINCOLN PARK PSYCHOLOGY, INC.
Practice Address 644 W Webster Ave # B
Chicago
IL 60614-3710
Practice Telephone 7739913016
Mailing Telephone 7739913016
Enumeration Date 2020-09-25
Last Update Date 2020-10-23
Authorized Official Name DR. KATHRYN JESSIE WAX (CLINICAL PSYCHOLOGIST/PRESIDENT)
Authorized Official Telephone 7739913016
Authorized Official Credential PSY.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103T00000X Psychologist Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
IL 1497137046 05

Office Location

Street Address 644 W WEBSTER AVE # B
City CHICAGO
State IL
Zip Code 60614-3710

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Taxonomy Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Notes: Source: American Psychological Association [1/1/2007: modified definition]

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1124660022 Lynne Lieberman Psychologist 325 S Paulina St, Chicago, IL 60612-3206 2019-10-11
1003462821 Michael Marek Maka Psychologist 820 W. Jackson Blvd, Suite 515, Chicago, IL 60607 2019-08-16
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Competitor

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City CHICAGO
Zip Code 60614

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Dataset Information

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.

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