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General NPI Number Information
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NPI Number | 1184286213
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Entity Type | Organization
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Legal Business Name | NOVAK COUNSELING, P.C.
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Dates
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Enumeration Date | 06/28/2019
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Last Update Date | 06/28/2019
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Provider Practice Location Address
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Address Line | 1020 MILWAUKEE AVE
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City | DEERFIELD
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State | IL
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Zip | 60015-3513
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Country | US
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Telephone | 847-651-4684
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Fax |
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Provider Business Mailing Address
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Address Line | 16210 W POPE BLVD
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City | PRAIRIE VIEW
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State | IL
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Zip | 60069-9683
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Country | US
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Telephone | 847-651-4684
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. LAURA NOVAK
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Credential | LCSW, CADC
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Telephone | 847-651-4684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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