Provider Demographics
NPI:1437619368
Name:GRAY OAK COUNSELING LLC
Entity Type:Organization
Organization Name:GRAY OAK COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNFELD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-920-4556
Mailing Address - Street 1:9740 KEDVALE AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1122
Mailing Address - Country:US
Mailing Address - Phone:847-920-4556
Mailing Address - Fax:
Practice Address - Street 1:2550 CRAWFORD AVE
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4900
Practice Address - Country:US
Practice Address - Phone:847-920-4556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health