MEDICARE: SER ES MENTAL HEALTH SERVICES, PLLC

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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1053102244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SER ES MENTAL HEALTH SERVICES, PLLC

Provider Business Mailing Address
First Line	:	1754 N TROY ST UNIT 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-5019
Country	:	US
Telephone Number	:	786-302-1182
Fax Number	:

Provider Business Practice Location Address
First Line	:	1754 N TROY ST UNIT 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-5019
Country	:	US
Telephone Number	:	786-302-1182
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOTHERAPIST
Name	:	VALERIA LAZO
Credential	:	LCSW
Telephone Number	:	786-302-1182

Provider Enumeration Date	:	05/15/2025
Last Update Date	:	05/15/2025

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