Provider Demographics
NPI:1114426533
Name:BARAN, ANASTASIA (LCSW)
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:
Last Name:BARAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 GOLF MILL CTR STE 708
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1208
Mailing Address - Country:US
Mailing Address - Phone:847-824-8366
Mailing Address - Fax:
Practice Address - Street 1:241 GOLF MILL CTR STE 708
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1208
Practice Address - Country:US
Practice Address - Phone:847-824-8366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490196621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical