Provider Demographics
NPI:1083372791
Name:ALHARBI, BADRIAH S (MSW)
Entity Type:Individual
Prefix:
First Name:BADRIAH
Middle Name:S
Last Name:ALHARBI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2144 W DEVON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-2165
Mailing Address - Country:US
Mailing Address - Phone:773-739-9079
Mailing Address - Fax:773-739-9080
Practice Address - Street 1:2144 W DEVON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-2165
Practice Address - Country:US
Practice Address - Phone:773-739-9079
Practice Address - Fax:773-739-9080
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036844259006001Medicaid