MEDICARE: LJT THERAPEUTICS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1013663368
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LJT THERAPEUTICS

Provider Business Mailing Address
First Line	:	701 MARKET ST
Second Line	:	SUITE 110 PMB 1983
City	:	SAINT LOUIS
State	:	MO
Zip	:	63101-1824
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1130 S CANAL ST STE 1177
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60607-5058
Country	:	US
Telephone Number	:	773-600-6667
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LAHAJI THOMAS
Credential	:	LCSW
Telephone Number	:	773-600-6667

Provider Enumeration Date	:	02/25/2022
Last Update Date	:	09/08/2025

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Directions to “LJT THERAPEUTICS ” Practice Location

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