Provider Demographics
NPI:1417418617
Name:LAUREN RAPHAEL LCSW LLC
Entity Type:Organization
Organization Name:LAUREN RAPHAEL LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAPHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-953-1471
Mailing Address - Street 1:622 DUNSTEN CIR
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2613
Mailing Address - Country:US
Mailing Address - Phone:312-953-1471
Mailing Address - Fax:
Practice Address - Street 1:707 SKOKIE BLVD STE 622
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2857
Practice Address - Country:US
Practice Address - Phone:312-953-1471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-29
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty