=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306724711
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PERCEPTIVITY COUNSELING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/25/2025
-----------------------------------------------------
Last Update Date | 08/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1719 W AINSLIE ST APT 2
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60640-8242
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 312-914-6601
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4601 N CLARK ST # 1008
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60640-4619
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER, PSYCHOTHERAPIST
-----------------------------------------------------
Name | RICKY N HEDENSTROM
-----------------------------------------------------
Credential | LCPC
-----------------------------------------------------
Telephone | 312-914-6601
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------