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NPI Code Detail

MEDICARE: COLLECTIVE SHAKTI COUNSELING PC

MEDICARE: COLLECTIVE SHAKTI COUNSELING PC
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1295672996
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLLECTIVE SHAKTI COUNSELING PC
Provider Business Mailing Address
First Line : 213 W INSTITUTE PL STE 500
Second Line :
City : CHICAGO
State : IL
Zip : 60610-8792
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 213 W INSTITUTE PL STE 500
Second Line :
City : CHICAGO
State : IL
Zip : 60610-8792
Country : US
Telephone Number : 530-447-0111
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : CHANDRA SHANMUGAVEL
Credential : LPCC, LCPC, NCC
Telephone Number : 609-433-8625
Provider Enumeration Date : 04/30/2026
Last Update Date : 04/30/2026

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