1801928734 NPI number — THE COUNSELORS' OFFICE

Table of content: LAWRENCE DAVID BET-VARDA (NPI 1851187561)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801928734 NPI number — THE COUNSELORS' OFFICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE COUNSELORS' OFFICE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801928734
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3759 W 95TH ST
Provider Second Line Business Mailing Address:
SUITE #3
Provider Business Mailing Address City Name:
EVERGREEN PARK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60805-2000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
708-535-2777
Provider Business Mailing Address Fax Number:
773-233-1440

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3759 W 95TH ST
Provider Second Line Business Practice Location Address:
SUITE #3
Provider Business Practice Location Address City Name:
EVERGREEN PARK
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60805-2000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-535-2777
Provider Business Practice Location Address Fax Number:
773-233-1440
Provider Enumeration Date:
03/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KELLY
Authorized Official First Name:
MARGARET
Authorized Official Middle Name:
Authorized Official Title or Position:
COUNSELOR
Authorized Official Telephone Number:
708-535-2777

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com