Address: 1606 W Wallen Ave Apt 1, Chicago, IL 60626-6592

CHARLES CHEVELL HURT (NPI# 1619597259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1619597259
Entity Type Individual
Gender Male
Practice Address 1606 W Wallen Ave Apt 1
IL 60626-6592
Practice Telephone 7736809695
Mailing Address 1606 W Wallen Ave Apt 1
IL 60626-6592
Mailing Telephone 7736809695
Certification Date 2020-04-23
Enumeration Date 2020-04-23
Last Update Date 2020-04-23
Is Sole Proprietor Y


Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
Y 101Y00000X Counselor 193200000X MULTI-SPECIALTY GROUP Behavioral Health & Social Service Providers
N 225X00000X Occupational Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Office Location

Street Address 1606 W WALLEN AVE APT 1
State IL
Zip Code 60626-6592

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1679885180 Rita J Dolis I · Rita J Dolis Counselor - Addiction (Substance Use Disorder) 1607 W Howard, Third Fl, Chicago, IL 60626 2010-07-13
1740873934 Peace Emechebe Nurse Practitioner - Primary Care 1930 West Estes Ave, Chicago, IL 60626 2021-02-18
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1972948206 Donna Darcell Smith Counselor - Addiction (Substance Use Disorder) 1401 West Jarvis Ave., #2e, Chicago, IL 60626 2013-04-30
1386858025 Lester and Rosalie Anixter Center · Anixter Center Community/Behavioral Health 6610 N. Clark Street, Chicago, IL 60626 2007-05-10
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Taxonomy Information

Taxonomy Code 101Y00000X
Grouping Behavioral Health & Social Service Providers
Classification Counselor

Taxonomy Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification.
Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors.

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NPI Name Taxonomy Address Enumeration
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1093385569 Keila Pope Counselor 3708 N Ashland Ave, Chicago, IL 60613-5272 2021-06-28
1790352888 Rebecca Ebben Counselor 1616 N Damen Ave Ste 301, Chicago, IL 60647-5536 2021-06-07
1912573494 Elizabeth Quinn Davis Counselor 155 N Michigan Ave Ste 444, Chicago, IL 60601-7511 2021-06-03
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1013590215 Falechia N Turman Counselor 5080 N Elston Ave, Chicago, IL 60630-2459 2021-05-04
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1457937542 Jamila Ford Counselor 5425 W Van Buren St, Chicago, IL 60644-4745 2021-03-20
1124603857 Liana Ramon Counselor 1525 E 53rd St Ste 1009, Chicago, IL 60615-4547 2021-03-15
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Zip Code 60626

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.