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General NPI Number Information
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NPI Number | 1780450643
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Entity Type | Organization
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Legal Business Name | MILLENNIUM BEHAVIOR HEALTH SERVICES
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Dates
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Enumeration Date | 11/30/2023
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 2441 W 79TH ST
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City | CHICAGO
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State | IL
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Zip | 60652-1734
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Country | US
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Telephone | 773-306-2975
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Fax | 872-267-7166
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Provider Business Mailing Address
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Address Line | 2441 W 79TH ST
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City | CHICAGO
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State | IL
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Zip | 60652-1734
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Country | US
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Telephone | 773-306-2975
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Fax | 872-267-7166
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. BRENDA JOYCE GOLDEN
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Credential |
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Telephone | 773-306-2975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #8
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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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