14D2209640 CLIA NUMBER - NORTH SHORE SCHOOL DISTRICT 112

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Laboratory Demographics

CLIA Number: 14D2209640

Facility Name: NORTH SHORE SCHOOL DISTRICT 112

Facility Address:
1936 GREEN BAY RD
HIGHLAND PARK, IL
ZIP 60035
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Facility Phone Number: 224 765-3002

Facility Type: School/Student Health Service

Certificate Type: Waiver

NPI Number: 1154814713

Taxonomy: 103TC0700X - Psychologist
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.

CLIA Record

Field Name	Field Value
CLIA Number	14D2209640
LAB Type	School/Student Health Service
Facility Name	NORTH SHORE SCHOOL DISTRICT 112
Street	1936 GREEN BAY RD
City	HIGHLAND PARK
State	IL
ZIP	60035
Phone	224 765-3002
CertificateType	4
CertificateEffectiveDate	1/14/2023
CertificateExpirationDate	1/13/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024