Provider Demographics
NPI:1447029988
Name:THE DEPTH COLLECTIVE PLLC
Entity type:Organization
Organization Name:THE DEPTH COLLECTIVE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAYAT
Authorized Official - Middle Name:
Authorized Official - Last Name:NADAR
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:810-701-8029
Mailing Address - Street 1:4707 N BROADWAY ST STE 304
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-7900
Mailing Address - Country:US
Mailing Address - Phone:708-232-3350
Mailing Address - Fax:
Practice Address - Street 1:4707 N BROADWAY ST STE 304
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-7900
Practice Address - Country:US
Practice Address - Phone:708-232-3350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-26
Last Update Date:2024-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty