BLACK TIE THERAPY
NPI 1073156196
Community/Behavioral Health in Chicago, IL

Active since October 21, 2019
2232 N WAYNE AVE APT 1F, CHICAGO, IL 60614(773) 217-8426 Get Directions Write a Review

NPPES record last updated: September 4, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 4, 2020, Oct 21, 2019 (2 updates tracked since 2019).

About Black Tie Therapy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLACK TIE THERAPY (NPI 1073156196) is a healthcare organization registered as a community/behavioral health in Chicago, Illinois and active in the NPI registry since October 2019. The organization lists Myron Nelson, President, as its authorized official.

NPPES Registry Identity

NPI1073156196
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameBLACK TIE THERAPY
Location Address2232 N WAYNE AVE APT 1FChicago, IL 60614-8937
Mailing Address2232 N Wayne Ave Apt 1fChicago, IL 60614-8937
Organization SubpartNo
Authorized OfficialMyron NelsonPresident · (216) 832-1907
Enumeration DateOctober 21, 2019
Last NPPES UpdateSeptember 4, 20202 updates tracked since enumeration
NPPES CertifiedSeptember 4, 2020
NPI 1073156196 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

2232 N WAYNE AVE APT 1F, Chicago, IL 60614

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Marriage & Family Therapist
2232 N WAYNE AVE APT 1F
CHICAGO, IL 60614

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1073156196, enumerated as an "organization" on October 21, 2019.

The provider is located at 2232 N WAYNE AVE APT 1F CHICAGO, IL 60614 and the phone number is (773) 217-8426.

Community/Behavioral Health with taxonomy code 251S00000X.