| Tmh Behavioral Services P.c. | |
|
710 E 47th St Ste 203w Chicago IL 60653-0120 | |
| (773) 828-4940 | |
| Not Available |
| Full Name | Tmh Behavioral Services P.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 710 E 47th St Ste 203w, Chicago, Illinois |
| Authorized Official Name and Position | Tytannie Harris (OWNER) |
| Authorized Official Contact | 7737017486 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tmh Behavioral Services P.c. 710 E 47th St Ste 203w Chicago IL 60653-0120 Ph: (773) 828-4940 | Tmh Behavioral Services P.c. 710 E 47th St Ste 203w Chicago IL 60653-0120 Ph: (773) 828-4940 |
| NPI Number | 1164997284 |
|---|---|
| Provider Enumeration Date | 10/04/2018 |
| Last Update Date | 11/18/2019 |
| Medicare PECOS PAC ID | 2264737618 |
|---|---|
| Medicare Enrollment ID | O20160223000042 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164997284 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Tytannie M Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144646621 PECOS PAC ID: 6709019888 Enrollment ID: I20140424001579 |
| Provider Name | Gwen M Vana |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669720991 PECOS PAC ID: 8022372010 Enrollment ID: I20180427000040 |
| Provider Name | Katya Cerrato |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609468487 PECOS PAC ID: 0042667966 Enrollment ID: I20231114001111 |
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