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LUTHERAN SOCIAL SERVICES OF ILLINOIS NPI 1639393499


NPI Information

NPI: 1639393499
Provider Name: LUTHERAN SOCIAL SERVICES OF ILLINOIS

Other Name: FAR NORTHWEST COUNSELING

Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
6321 N AVONDALE AVE
SUITE A 101
CHICAGO, IL
ZIP 60631
Phone: (773) 774-7555
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LUTHERAN SOCIAL SERVICES OF ILLINOIS is a clinical psychologist in Chicago, IL. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. LUTHERAN SOCIAL SERVICES OF ILLINOIS NPI is 1639393499. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Far Northwest Counseling.

The provider's business location address is:

6321 N AVONDALE AVE
SUITE A 101
CHICAGO, IL
ZIP 60631-900
Phone: (773) 774-7555
Fax: (773) 774-8910

The provider's authorized official is Gerald Noonan .
The authorized official title is Chief Financial Officer and has the following contact phone number (847) 635-4600.

The enumeration date for this NPI number is 4/12/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC0700XPsychologistClinicalYes
21041C0700XSocial WorkerClinicalX
3261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10001617952OTHERILLINOISBLUE CROSS BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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