Healthcare Provider Details

I. General information

NPI: 1427507169
Provider Name (Legal Business Name): RAJYA KARIPINENI LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2016
Last Update Date: 08/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 W JACKSON BLVD STE 1700
CHICAGO IL
60604-3597
US

IV. Provider business mailing address

111 W JACKSON BLVD STE 1700
CHICAGO IL
60604-3597
US

V. Phone/Fax

Practice location:
  • Phone: 773-888-2291
  • Fax:
Mailing address:
  • Phone: 773-888-2291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number149.019689
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number150.101629
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: