Provider Demographics
NPI:1669135307
Name:CENTERED MIND PSYCHOTHERAPY, PLLC
Entity type:Organization
Organization Name:CENTERED MIND PSYCHOTHERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:EMERY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:312-925-0194
Mailing Address - Street 1:53 W JACKSON BLVD STE 1334
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604-3548
Mailing Address - Country:US
Mailing Address - Phone:312-925-0194
Mailing Address - Fax:
Practice Address - Street 1:53 W JACKSON BLVD STE 1334
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604-3548
Practice Address - Country:US
Practice Address - Phone:312-725-0194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty