Organization
SELF THEORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANISHA HINES (OWNER/DIRECTOR)
(773) 569-0791
Entity
Organization
Contact information
Practice address
770 N HALSTED ST STE 306, CHICAGO, IL 60642-8407
(312) 973-8687
Mailing address
770 N HALSTED ST STE 306, CHICAGO, IL 60642-8407
(312) 973-8687
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
03/06/2024
Last updated
04/10/2026
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