Organization · NPI-2
A Beautiful Mind, INC
Clinic/Center, Mental Health (Including Community Mental Health Center) · Chicago, IL
NPI number1245036672
StatusActive
Last updated in NPPESFeb 25, 2025
Details
- NPI
- 1245036672
- Entity type
- Organization (NPI-2)
- Legal business name
- A Beautiful Mind, INC
- Organization subpart
- No
- Enumeration date
- Feb 25, 2025
- Certification date
- Feb 13, 2025
- Last updated
- Feb 25, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
| 101YM0800X | Counselor, Mental Health | – | – |
Practice location
5113 S Harper Ave Ste 2cChicago, IL 60615-4119
Phone 312-340-8826 · Fax 773-304-4555
Mailing address
5113 S Harper Ave Ste 2cChicago, IL 60615-4119
Phone 312-340-8826 · Fax 773-304-4555
Authorized official
Chiquita Lee
Ceo
7733043699
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