MEDICARE: LUCKY7 PSYCHOTHERAPY PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1255293734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUCKY7 PSYCHOTHERAPY PLLC

Provider Business Mailing Address
First Line	:	1020 W BRYN MAWR AVE STE 432
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60660-4627
Country	:	US
Telephone Number	:	872-327-3007
Fax Number	:	872-241-0399

Provider Business Practice Location Address
First Line	:	1020 W BRYN MAWR AVE STE 432
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60660-4627
Country	:	US
Telephone Number	:	872-327-3007
Fax Number	:	872-241-0399

Authorized Official
Title or Position	:	THERAPIST
Name	:	TESS BRIEVA
Credential	:	LCSW
Telephone Number	:	872-327-3007

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

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