MANDALA COUNSELING & PSYCHOLOGICAL SERVICES, PLLC
NPI 1538724364
Psychologist in Chicago, IL

Active since May 07, 2019
5212 N. CLARK STREET, SUITE 222, CHICAGO, IL 60640(773) 454-7202(773) 465-5041 Get Directions Write a Review

NPPES record last updated: May 7, 2019. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Mandala Counseling & Psychological Services, Pllc NPPES

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

MANDALA COUNSELING & PSYCHOLOGICAL SERVICES, PLLC (NPI 1538724364) is a healthcare organization registered as a psychologist in Chicago, Illinois and active in the NPI registry since May 2019. The organization lists Kenneth Jackson, Owner, as its authorized official.

NPPES Registry Identity

NPI1538724364
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameMANDALA COUNSELING & PSYCHOLOGICAL SERVICES, PLLC
Location Address5212 N. CLARK STREET, SUITE 222Chicago, IL 60640-1223
Mailing Address5212 N. Clark Street, Suite 222Chicago, IL 60640-1223 · (773) 454-7202 · Fax (773) 465-5041
Fax(773) 465-5041
Organization SubpartNo
Authorized OfficialKenneth JacksonOwner · (773) 454-7202
Enumeration DateMay 7, 2019
NPI 1538724364 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedCounselorTaxonomy 101Y00000X
5212 N. CLARK STREET, Chicago, IL 60640

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mandala Counseling & Psychological Services, PLLC's NPI number?

The NPI number for Mandala Counseling & Psychological Services, PLLC is 1538724364. It was assigned to this organization in the NPPES registry on May 7, 2019.

Where is Mandala Counseling & Psychological Services, PLLC located?

Mandala Counseling & Psychological Services, PLLC is located at 5212 N. Clark Street Suite 222, Chicago, IL 60640. The listed phone number is (773) 454-7202.

What is Mandala Counseling & Psychological Services, PLLC's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

When was this NPI record last updated?

The NPPES record for Mandala Counseling & Psychological Services, PLLC was last updated on May 7, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.