Healthcare Provider Details

I. General information

NPI: 1316800980
Provider Name (Legal Business Name): PIVOT BEHAVIORAL HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 W BRIAR PL STE 6
CHICAGO IL
60657-4560
US

IV. Provider business mailing address

611 W BRIAR PL STE 6
CHICAGO IL
60657-4560
US

V. Phone/Fax

Practice location:
  • Phone: 773-234-1721
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number
License Number State

VIII. Authorized Official

Name: EMERSON EPSTEIN
Title or Position: OWNER
Credential: PHD
Phone: 773-234-1721