Provider Demographics
NPI:1235364035
Name:KAHAN, LAWRENCE MARTIN (LCPC)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:MARTIN
Last Name:KAHAN
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 MANCHESTER CRSE
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-3408
Mailing Address - Country:US
Mailing Address - Phone:630-205-2848
Mailing Address - Fax:630-208-0310
Practice Address - Street 1:912 MANCHESTER CRSE
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-3408
Practice Address - Country:US
Practice Address - Phone:630-205-2848
Practice Address - Fax:630-208-0310
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-22
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.006698101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health