Provider Demographics
NPI:1417063900
Name:VARNAVA, MARIA (LCPC)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:VARNAVA
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5691 N RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-3420
Mailing Address - Country:US
Mailing Address - Phone:773-303-3000
Mailing Address - Fax:773-765-0701
Practice Address - Street 1:5691 N RIDGE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-3420
Practice Address - Country:US
Practice Address - Phone:773-303-3000
Practice Address - Fax:773-765-0701
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional