MEDICARE: STAY LIFTED PSYCHIATRY AND WELLNESS 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	:	1962352989
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAY LIFTED PSYCHIATRY AND WELLNESS PLLC

Provider Business Mailing Address
First Line	:	680 N LAKE SHORE DR STE 110-2647
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-4546
Country	:	US
Telephone Number	:	815-274-8246
Fax Number	:

Provider Business Practice Location Address
First Line	:	680 N LAKE SHORE DR STE 110-2647
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-4546
Country	:	US
Telephone Number	:	815-274-8246
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TIFFANY GUTHRIE
Credential	:	PMHNP
Telephone Number	:	815-274-8246

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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