MEDICARE: CLINICAL SOLUTIONS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1114811643
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICAL SOLUTIONS, PLLC

Provider Business Mailing Address
First Line	:	20 PALMER PINES RD
Second Line	:
City	:	HAMILTON
State	:	GA
Zip	:	31811-4408
Country	:	US
Telephone Number	:	773-880-8820
Fax Number	:	773-880-8469

Provider Business Practice Location Address
First Line	:	680 N LAKE SHORE DRIVE
Second Line	:	SUITE 110#2756
City	:	CHICAGO
State	:	IL
Zip	:	60611-4447
Country	:	US
Telephone Number	:	773-880-8820
Fax Number	:	773-880-8469

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN W HENSON III
Credential	:	LCSW
Telephone Number	:	773-880-8820

Provider Enumeration Date	:	06/09/2025
Last Update Date	:	06/09/2025

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