Provider Demographics
NPI:1275049454
Name:LOGAN & ASSOCIATES COUNSELING SESRVICES
Entity Type:Organization
Organization Name:LOGAN & ASSOCIATES COUNSELING SESRVICES
Other - Org Name:LANA LOGAN LCPC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LANA
Authorized Official - Middle Name:YAEL
Authorized Official - Last Name:LOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:708-514-9422
Mailing Address - Street 1:13161 W 143RD ST
Mailing Address - Street 2:
Mailing Address - City:HOMER GLEN
Mailing Address - State:IL
Mailing Address - Zip Code:60491-6890
Mailing Address - Country:US
Mailing Address - Phone:708-514-9422
Mailing Address - Fax:815-230-1380
Practice Address - Street 1:13161 W 143RD ST
Practice Address - Street 2:
Practice Address - City:HOMER GLEN
Practice Address - State:IL
Practice Address - Zip Code:60491-6890
Practice Address - Country:US
Practice Address - Phone:708-514-9422
Practice Address - Fax:815-230-1380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-24
Last Update Date:2017-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007562101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty