Provider Demographics
NPI:1508012360
Name:LAUREL LAFORCE, LSCW, CADC
Entity Type:Organization
Organization Name:LAUREL LAFORCE, LSCW, CADC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREL
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFORCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-880-1353
Mailing Address - Street 1:1300 W. BELMONT
Mailing Address - Street 2:#314
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657
Mailing Address - Country:US
Mailing Address - Phone:773-880-1353
Mailing Address - Fax:773-880-1323
Practice Address - Street 1:1300 W. BELMONT
Practice Address - Street 2:#314
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657
Practice Address - Country:US
Practice Address - Phone:773-880-1353
Practice Address - Fax:773-880-1323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0033421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty