Provider Demographics
NPI:1083899769
Name:ATHAR, NAVEEDA (LCPC)
Entity Type:Individual
Prefix:
First Name:NAVEEDA
Middle Name:
Last Name:ATHAR
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 S SCHMALE RD
Mailing Address - Street 2:SUITE # 140 B
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2791
Mailing Address - Country:US
Mailing Address - Phone:630-842-2729
Mailing Address - Fax:630-933-9056
Practice Address - Street 1:380 S SCHMALE RD
Practice Address - Street 2:SUITE #140B
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2791
Practice Address - Country:US
Practice Address - Phone:630-842-2729
Practice Address - Fax:630-933-9056
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005355101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02233176OtherBCBSIL