Provider Demographics
NPI:1588163653
Name:THREE TALES THERAPY
Entity type:Organization
Organization Name:THREE TALES THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLIESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-885-4147
Mailing Address - Street 1:2150 W ARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-5580
Mailing Address - Country:US
Mailing Address - Phone:773-885-4147
Mailing Address - Fax:
Practice Address - Street 1:4800 N MILWAUKEE AVE STE 205B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-3189
Practice Address - Country:US
Practice Address - Phone:773-599-1609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-05
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0178111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty