MEDICARE: CENTERED HEALING THERAPY 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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1427737253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTERED HEALING THERAPY PLLC

Provider Business Mailing Address
First Line	:	4800 N MILWAUKEE AVE STE 202
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-2156
Country	:	US
Telephone Number	:	773-809-4920
Fax Number	:

Provider Business Practice Location Address
First Line	:	4800 N MILWAUKEE AVE STE 202
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-2156
Country	:	US
Telephone Number	:	773-809-4920
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SARAH RAZO
Credential	:	LCSW
Telephone Number	:	773-809-4920

Provider Enumeration Date	:	07/18/2023
Last Update Date	:	07/18/2023

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