Provider Demographics
NPI:1114519576
Name:SHAH, PARINBEN R (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:PARINBEN
Middle Name:R
Last Name:SHAH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:PARIN
Other - Middle Name:
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:617 W MILLERS RD
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-2560
Mailing Address - Country:US
Mailing Address - Phone:224-723-4597
Mailing Address - Fax:
Practice Address - Street 1:3525 W PETERSON AVE STE 522
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-3317
Practice Address - Country:US
Practice Address - Phone:224-723-4597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-08
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490228201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty