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NPI Code Detail

MEDICARE: SARAI FARIAS LMFT

MEDICARE:   SARAI  FARIAS  LMFT
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
1106H00000XMarriage & Family Therapist166.001740IL

General Provider Information

NPI Number : 1629823125
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAI FARIAS LMFT
Provider Business Mailing Address
First Line : 2600 RIDGELAND AVE
Second Line :
City : BERWYN
State : IL
Zip : 60402-2725
Country : US
Telephone Number : 708-317-5926
Fax Number : 708-637-4316
Provider Business Practice Location Address
First Line : 2600 RIDGELAND AVE
Second Line :
City : BERWYN
State : IL
Zip : 60402-2725
Country : US
Telephone Number : 708-317-5926
Fax Number : 708-637-4316
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2024
Last Update Date : 04/19/2024

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