Provider Demographics
NPI:1568353654
Name:MALACHITE INSTITUTE FOR BEHAVIORAL HEALTH, INC
Entity type:Organization
Organization Name:MALACHITE INSTITUTE FOR BEHAVIORAL HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:KASSEM
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD PHD
Authorized Official - Phone:773-865-9286
Mailing Address - Street 1:609 SOUTH BLVD APT A
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2937
Mailing Address - Country:US
Mailing Address - Phone:773-865-9286
Mailing Address - Fax:
Practice Address - Street 1:609 SOUTH BLVD APT A
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2937
Practice Address - Country:US
Practice Address - Phone:240-802-2983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty