Provider Demographics
NPI:1114532561
Name:NEFESH COUNSELING, LLC
Entity Type:Organization
Organization Name:NEFESH COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCPC
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:TAMAR
Authorized Official - Last Name:PROVORNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-645-1443
Mailing Address - Street 1:3320 W FOSTER AVE # 124
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-4813
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3320 W FOSTER AVE # 124
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-4813
Practice Address - Country:US
Practice Address - Phone:773-645-1443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-12
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty