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 is a Professional Counselor 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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