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General NPI Number Information
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NPI Number | 1447847579
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Entity Type | Organization
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Legal Business Name | CENTERED PATH THERAPY PLLC
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Dates
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Enumeration Date | 12/22/2020
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 3323 W DIVERSEY AVE # 17
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City | CHICAGO
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State | IL
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Zip | 60647-8582
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Country | US
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Telephone | 773-340-2517
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Fax | 872-702-6454
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Provider Business Mailing Address
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Address Line | 2304 N SPAULDING AVE
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City | CHICAGO
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State | IL
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Zip | 60647-2520
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | TAYLOR LEYH MOORE
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Credential | LCSW, CADC
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Telephone | 630-405-8394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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