Healthcare Provider Details

I. General information

NPI: 1164359824
Provider Name (Legal Business Name): UNTANGLED THOUGHTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6526 N ASHLAND AVE APT 2
CHICAGO IL
60626-4941
US

IV. Provider business mailing address

6526 N ASHLAND AVE APT 2
CHICAGO IL
60626-4941
US

V. Phone/Fax

Practice location:
  • Phone: 406-303-9708
  • Fax:
Mailing address:
  • Phone: 406-303-9708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDER JAYDEN PETERS
Title or Position: OWNER
Credential:
Phone: 406-303-9708