Provider Demographics
NPI:1639755614
Name:TRUE SELF PSYCHOTHERAPY LLC
Entity type:Organization
Organization Name:TRUE SELF PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF PRACITCE
Authorized Official - Prefix:
Authorized Official - First Name:NIDHI
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIVEDI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:312-912-4314
Mailing Address - Street 1:4000 W MONTROSE AVE # 832
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-2140
Mailing Address - Country:US
Mailing Address - Phone:312-912-4314
Mailing Address - Fax:
Practice Address - Street 1:4000 W MONTROSE AVE # 832
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-2140
Practice Address - Country:US
Practice Address - Phone:312-912-4314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-22
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty