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NPI Code Detail

MEDICARE: BREANNA T TRAUB LCSW

MEDICARE:   BREANNA T TRAUB  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker149.020606IL

General Provider Information

NPI Number : 1043785967
Entity Type Code : Individual
Provider Name (Legal Business Name) : BREANNA T TRAUB LCSW
Provider Business Mailing Address
First Line : 1249 WAUKEGAN RD
Second Line :
City : GLENVIEW
State : IL
Zip : 60025-3077
Country : US
Telephone Number : 847-400-4462
Fax Number :
Provider Business Practice Location Address
First Line : 1249 WAUKEGAN RD
Second Line :
City : GLENVIEW
State : IL
Zip : 60025-3077
Country : US
Telephone Number : 847-400-4462
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2018
Last Update Date : 08/24/2023

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Directions to “ BREANNA T TRAUB LCSW” Practice Location

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