Healthcare Provider Details

I. General information

NPI: 1306631965
Provider Name (Legal Business Name): BRIGHT BIRDS PSYCHOTHERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4915 W GRACE ST UNIT 1
CHICAGO IL
60641-3506
US

IV. Provider business mailing address

4915 W GRACE ST UNIT 1
CHICAGO IL
60641-3506
US

V. Phone/Fax

Practice location:
  • Phone: 312-783-0969
  • Fax:
Mailing address:
  • Phone: 312-783-0969
  • 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: MR. DANIEL HAUFF
Title or Position: MANAGING MEMBER
Credential: LCPC
Phone: 312-783-0969