SELF CONNECTED THERAPY LLC – NPI #1013521301
Clinic/Center

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

Health Care Provider Taxonomy Code for Clinic/Center

SELF CONNECTED THERAPY LLC is an AHC clinic located in ROUND LAKE BEACH, IL. NPPES has assigned the NPI number 1013521301 to SELF CONNECTED THERAPY LLC on September 03, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QM0850X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Adult Mental Health

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SELF CONNECTED THERAPY LLC below.

NPI Profile for
SELF CONNECTED THERAPY LLC

NPI Number
1013521301
Enumeration Date

(about 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SELF CONNECTED THERAPY LLC
Primary location
2189 N. RT. 83
#292
ROUND LAKE BEACH, IL 60073
Phone: (847) 942-7849 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
ASHLEY GROB
THERAPIST
Phone: (847) 942-7849
Updated
Certification Date
Aug 31, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM0850X
- Clinic/Center / Adult Mental Health (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.