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General NPI Number Information
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NPI Number | 1336787662
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Entity Type | Organization
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Legal Business Name | MEIRA KATZOFF LCSW, LLC
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Dates
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Enumeration Date | 12/17/2019
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Last Update Date | 12/17/2019
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Provider Practice Location Address
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Address Line | 4905 OLD ORCHARD CTR STE 510
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City | SKOKIE
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State | IL
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Zip | 60077-4736
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Country | US
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Telephone | 847-410-9129
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Fax |
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Provider Business Mailing Address
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Address Line | 9043 FORESTVIEW RD
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City | EVANSTON
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State | IL
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Zip | 60203-1912
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Country | US
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Telephone | 414-698-8525
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MEIRA YAEL KATZOFF
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Credential | LCSW
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Telephone | 847-410-9129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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