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General NPI Number Information
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NPI Number | 1780816900
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Entity Type | Individual
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Provider Name | BRIAN ROBERT MCLAUGHLIN LMFT
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Gender | Male
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Dates
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Enumeration Date | 08/21/2009
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Last Update Date | 03/27/2013
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Provider Practice Location Address
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Address Line | 2825 W MCLEAN AVE
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City | CHICAGO
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State | IL
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Zip | 60647-6431
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Country | US
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Telephone | 773-865-6455
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Fax | 773-278-2456
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Provider Business Mailing Address
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Address Line | 2521 N TALMAN AVE
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City | CHICAGO
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State | IL
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Zip | 60647-1811
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Country | US
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Telephone | 773-865-6455
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Fax | 773-278-7456
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 20042617A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 166.000724
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License Number State | IL
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