MEDICARE: THERAPY KITCHEN, 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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1619833373
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPY KITCHEN, PLLC

Provider Business Mailing Address
First Line	:	2872 W 21ST PL APT 1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-5215
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2872 W 21ST PL APT 1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-5215
Country	:	US
Telephone Number	:	872-228-7578
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SARAH YI
Credential	:	LCPC
Telephone Number	:	872-228-7578

Provider Enumeration Date	:	12/26/2025
Last Update Date	:	12/26/2025

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