SUMMIT PSYCHOTHERAPY (NPI# 1215572649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215572649 |
| Entity Type | Organization |
| Organization Name | SUMMIT PSYCHOTHERAPY |
| Practice Address |
4753 N Broadway St Ste 1014 Chicago IL 60640-4990 |
| Mailing Address |
5842 N Wayne Ave Apt G Chicago IL 60660-1981 |
| Practice Telephone | 7736126206 |
| Mailing Telephone | 6084449146 |
| Enumeration Date | 2019-11-08 |
| Last Update Date | 2019-11-08 |
| Authorized Official Name | MR. ERICH H HEINTZEN IV (PSYCHOTHERAPIST) |
| Authorized Official Telephone | 7736126206 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Summit Psychotherapy, LLC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508887795 | Summit Psychotherapy | Case Management | 601 University Ave, 225, Sacramento, CA 95825-6775 | 2006-07-22 |
| Street Address |
4753 N BROADWAY ST STE 1014 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60640-4990 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821330085 | Tolga Levent Yenilmez | Physical Therapist | 4753 N Broadway St Ste 1014, Chicago, IL 60640-4990 | 2013-03-25 |
| 1073133500 | Bridgewrights LLC | Physical Therapist | 4753 N Broadway St Ste 1014, Chicago, IL 60640-4990 | 2020-04-24 |
| 1275180671 | Megan Robertson | Physical Therapist | 4753 N Broadway St Ste 1014, Chicago, IL 60640-4990 | 2019-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336754233 | Rci (wrs), LLC. | Clinic/Center | 5221-23 North Broadway, Chicago, IL 60640 | 2020-09-09 |
| 1548871916 | Borici Counseling LLC | Counselor | 4731 N Paulina St, Chicago, IL 60640 | 2020-08-11 |
| 1306319173 | Gerardo Garcia | Physician Assistant | Medical Staff Office, Weiss Memorial Hospital, 4646 N Marine Drive, Chicago, IL 60640 | 2019-01-04 |
| 1386121283 | Aea Optical Ventures, LLC | Clinic/Center | 4814 N Clark St, Chicago, IL 60640 | 2018-07-24 |
| 1023503885 | Lauren Vassiliades | Internal Medicine | Weiss Memorial Hospital, Medical Education Dpt., 4646 N. Marine Drive, C Elevators, 7th Flr. # 7100, Chicago, IL 60640 | 2018-06-25 |
| 1477061620 | Yesenia Vargas | Nurse Practitioner | 1025 W Sunnyside, Chicago, IL 60640 | 2018-01-22 |
| 1932622206 | Jasleen Kaur Brar | Internal Medicine | 4646 N. Marine Dr., Chicago, IL 60640 | 2017-07-19 |
| 1750802849 | Umer Mukhtar | Internal Medicine | 4646 N. Marine Dr. Med Ed Dept. C Elevators., Weiss Memorial Hospital. 7 Floor. #7100, Chicago, IL 60640 | 2017-06-29 |
| 1184144081 | Ellie Navidson | Registered Nurse | 1015 W Lawrence, 2nd Floor, Chicago, IL 60640 | 2017-06-21 |
| 1962932558 | Jennifer Stridh | Marriage & Family Therapist | 5125 N. Winthrop Ave, 1f, Chicago, IL 60640 | 2017-06-15 |
| Find all providers in zip 60640 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336022 | Web Healing Collective Pllc | Social Worker | 6207 N Springfield Ave, Chicago, IL 60659-1015 | 2020-11-06 |
| 1881295186 | Belva Marie Dibert | Social Worker | 6330 S Ingleside Ave Apt 3, Chicago, IL 60637-5784 | 2020-11-03 |
| 1861092835 | Lauren Less | Social Worker | 111 East Pearson St, Chicago, IL 60611 | 2020-10-29 |
| 1164022422 | Brittany Lauren Gatchell | Social Worker | 7448 N Damen Ave Apt 3n, Chicago, IL 60645-2258 | 2020-10-27 |
| 1467052803 | Seri Elaine Porter | Social Worker | 4258 N Greenview Ave Apt 2d, Chicago, IL 60613-1173 | 2020-10-26 |
| 1255930707 | Emily Ehrens | Social Worker | 303 W Institute Pl Ste 300, Chicago, IL 60610-3080 | 2020-10-25 |
| 1316546955 | Yesenia Maldonado | Social Worker | 3922 N Sayre Ave, Chicago, IL 60634-2329 | 2020-10-24 |
| 1144829201 | Andrea Hohf, Mscd, Lcsw | Social Worker | 564 W Randolph St Ste 248, Chicago, IL 60661-2218 | 2020-10-20 |
| 1215536693 | Miracleworks Therapy & Consulting LLC | Social Worker | 2138 S Indiana Ave, Chicago, IL 60616-4930 | 2020-10-18 |
| 1104425552 | Fifth Star Collective, LLC | Social Worker | 2711 N Lawndale Ave Unit 2, Chicago, IL 60647-1127 | 2020-10-17 |
| Find all providers in CHICAGO | ||||
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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.