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General NPI Number Information
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NPI Number | 1447496153
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Entity Type | Organization
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Legal Business Name | PARTNERS IN COUNSELING OF LAKE COUNTY LTD
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Dates
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Enumeration Date | 12/30/2008
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Last Update Date | 12/30/2008
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Provider Practice Location Address
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Address Line | 135 N GREENLEAF ST #204
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City | GURNEE
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State | IL
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Zip | 60031-3393
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Country | US
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Telephone | 847-672-6540
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Fax |
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Provider Business Mailing Address
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Address Line | 318 W HALF DAY RD #212
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City | BUFFALO GROVE
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State | IL
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Zip | 60089-6547
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Country | US
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Telephone | 847-672-6540
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. LAUREL S HAIBECK
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Credential | LCSW
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Telephone | 847-672-6540
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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 | 149013003
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149010108
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License Number State | IL
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