Provider Demographics
NPI:1063686475
Name:RAVINIA COUNSELING, LTD.
Entity Type:Organization
Organization Name:RAVINIA COUNSELING, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:SACHS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-514-7260
Mailing Address - Street 1:213 RAVINIA PARK RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-5253
Mailing Address - Country:US
Mailing Address - Phone:847-514-7260
Mailing Address - Fax:847-926-9936
Practice Address - Street 1:213 RAVINIA PARK RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-5253
Practice Address - Country:US
Practice Address - Phone:847-514-7260
Practice Address - Fax:847-926-9936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty