Provider Demographics
NPI:1497244206
Name:DISCOVER PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:DISCOVER PSYCHOLOGICAL SERVICES
Other - Org Name:DISCOVER PSYCHOLOGICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRAZIMY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-609-1475
Mailing Address - Street 1:333 N MICHIGAN AVE STE 1530
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-4000
Mailing Address - Country:US
Mailing Address - Phone:847-609-1475
Mailing Address - Fax:
Practice Address - Street 1:333 N MICHIGAN AVE STE 1530
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-4000
Practice Address - Country:US
Practice Address - Phone:847-609-1475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-07
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty