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NPI Code Detail

MEDICARE: CENTERED THERAPY CHICAGO PLLC

MEDICARE: CENTERED THERAPY CHICAGO 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
1103TC0700XClinical Psychologist071006357IL

General Provider Information

NPI Number : 1912328212
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTERED THERAPY CHICAGO PLLC
Provider Business Mailing Address
First Line : 1507 W LAWRENCE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60640-4702
Country : US
Telephone Number : 773-569-1468
Fax Number :
Provider Business Practice Location Address
First Line : 1507 W LAWRENCE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60640-4702
Country : US
Telephone Number : 773-569-1468
Fax Number : 855-938-2268
Authorized Official
Title or Position : OWNER
Name : BIANKA NICOLE HARDIN
Credential :
Telephone Number : 773-569-1468
Provider Enumeration Date : 01/04/2014
Last Update Date : 06/12/2026

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Directions to “CENTERED THERAPY CHICAGO PLLC ” Practice Location

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