Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fandom Behavioral Health Clinic PLLC

Organization Professional Counselor · NPI 1942913280

Fandom Behavioral Health Clinic PLLC provides Professional Counselor services in Chicago, Illinois. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

564 W Randolph St Unit 820
Chicago, IL 60661-2218
Phone: (708) 789-5669
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X

Record details

NPI number1942913280
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Larry Woods — Professional Counselor · (803) 719-3237
NPI enumeratedJanuary 2, 2023
Last updated in NPPESMarch 3, 2023
Certification dateMarch 3, 2023
Mailing address564 W Randolph St Unit 820, Chicago, IL 60661-2218

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