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

Black Tie Therapy

Organization Community/Behavioral Health Agency · NPI 1073156196

Black Tie Therapy is a Community/Behavioral Health Agency in Chicago, Illinois. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

2232 N Wayne Ave Apt 1F
Chicago, IL 60614-8937
Phone: (773) 217-8426
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Behavioral Health Agency (primary) Taxonomy 251S00000X

Record details

NPI number1073156196
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Myron Nelson — President · (216) 832-1907
NPI enumeratedOctober 21, 2019
Last updated in NPPESSeptember 4, 2020
Certification dateSeptember 4, 2020
Mailing address2232 N Wayne Ave Apt 1f, Chicago, IL 60614-8937

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