LIFE MADE KRYSTAL CLEAR LLC
NPI 1629817523
Social Worker - Clinical in Chicago, IL

Q: What is Life Made Krystal Clear LLC's NPI number?

The NPI number for Life Made Krystal Clear LLC is 1629817523. It was assigned to this organization in the NPPES registry on May 21, 2024.

Q: What is Life Made Krystal Clear LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Active since May 21, 2024

2045 W GRAND AVE STE B, CHICAGO, IL 60612(312) 933-3167 Get Directions Write a Review

NPPES record last updated: May 21, 2024. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Life Made Krystal Clear Llc NPPES

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

LIFE MADE KRYSTAL CLEAR LLC (NPI 1629817523) is a healthcare organization registered as a clinical in Chicago, Illinois and active in the NPI registry since May 2024. The organization lists Krystal Fowlkes, Child & Family Therapist, as its authorized official.

NPPES Registry Identity

NPI1629817523

Entity TypeOrganization

Primary Taxonomy1041C0700X

Legal Business NameLIFE MADE KRYSTAL CLEAR LLC

Location Address2045 W GRAND AVE STE BChicago, IL 60612-1577

Mailing Address2045 W Grand Ave Ste BChicago, IL 60612-1577

Phone(312) 933-3167

Organization SubpartNo

Authorized OfficialKrystal FowlkesChild & Family Therapist · (312) 933-3167

Enumeration DateMay 21, 2024

NPPES CertifiedMay 21, 2024

✔ NPI 1629817523 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

2045 W GRAND AVE STE B, Chicago, IL 60612

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

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

APRIL STEWART STOWERS FNP-C

Nurse Practitioner (Family)

2045 W GRAND AVE STE B
CHICAGO, IL 60612

Cook County (708) 630-1534

KIRSTY MACPHERSON

Counselor (Professional)

2045 W GRAND AVE STE B
CHICAGO, IL 60612

Cook County (630) 881-7904

MECKELL MILBURN NBC-HWC

Health and Wellness Coach

2045 W GRAND AVE STE B
CHICAGO, IL 60612

Cook County (888) 200-5492

JENNIFER LEANN GREEN PA-C

Physician Assistant (Medical)

2045 W GRAND AVE STE B
CHICAGO, IL 60612

Cook County (708) 630-1534

JILL F PAGANO

Health and Wellness Coach

2045 W GRAND AVE STE B
CHICAGO, IL 60612

Cook County (800) 827-7437

SAMANTHA ANNITZA LAZAR RD

Dietitian, Registered

2045 W GRAND AVE STE B, PMB 37767
CHICAGO, IL 60612

Cook County (800) 827-7437

MRS. LINDA GEORGETTE BOULWARE APRN

Nurse Practitioner (Family)

2045 W GRAND AVE STE B
CHICAGO, IL 60612

Cook County (888) 660-4425

SOPHBRIA WELLNESS AND BEHAVIORAL HEALTH PLLC

Nurse Practitioner (Psychiatric/Mental Health)

2045 W GRAND AVE STE B
CHICAGO, IL 60612

Cook County (773) 430-0686

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 Life Made Krystal Clear LLC's NPI number?

The NPI number for Life Made Krystal Clear LLC is 1629817523. It was assigned to this organization in the NPPES registry on May 21, 2024.

Where is Life Made Krystal Clear LLC located?

Life Made Krystal Clear LLC is located at 2045 W Grand Ave Ste B, Chicago, IL 60612. The listed phone number is (312) 933-3167.

What is Life Made Krystal Clear LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Life Made Krystal Clear LLC was last updated on May 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.