| Centered Path Therapy Llc | |
|
2823 N Milwaukee Ave Chicago IL 60618-7403 | |
| (773) 340-2517 | |
| (773) 688-1729 |
| Full Name | Centered Path Therapy Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2823 N Milwaukee Ave, Chicago, Illinois |
| Authorized Official Name and Position | Taylor Leyh Moore (PSYCHOTHERAPIST) |
| Authorized Official Contact | 6304058394 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centered Path Therapy Llc 2304 N Spaulding Ave Chicago IL 60647-2520 Ph: () - | Centered Path Therapy Llc 2823 N Milwaukee Ave Chicago IL 60618-7403 Ph: (773) 340-2517 |
| NPI Number | 1447847579 |
|---|---|
| Provider Enumeration Date | 12/22/2020 |
| Last Update Date | 04/13/2021 |
| Certification Date | 04/13/2021 |
| Medicare PECOS PAC ID | 7214345750 |
|---|---|
| Medicare Enrollment ID | O20210421001532 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447847579 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Taylor Leyh Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730428525 PECOS PAC ID: 8820358534 Enrollment ID: I20200109001805 |
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