Provider Demographics
NPI:1306607437
Name:CASTING A LIGHT PSYCHOTHERAPY, P.C.
Entity type:Organization
Organization Name:CASTING A LIGHT PSYCHOTHERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PERLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:312-298-9637
Mailing Address - Street 1:3320 W FOSTER AVE # 127
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-4813
Mailing Address - Country:US
Mailing Address - Phone:312-298-9637
Mailing Address - Fax:
Practice Address - Street 1:3320 W FOSTER AVE # 127
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-4813
Practice Address - Country:US
Practice Address - Phone:312-298-9637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-16
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty