Provider Demographics
NPI:1558966028
Name:NORTH SHORE THERAPY PLLC
Entity Type:Organization
Organization Name:NORTH SHORE THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KROE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:312-509-0785
Mailing Address - Street 1:550 MICHIGAN AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-4658
Mailing Address - Country:US
Mailing Address - Phone:312-509-0785
Mailing Address - Fax:
Practice Address - Street 1:550 MICHIGAN AVE APT 3
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-4658
Practice Address - Country:US
Practice Address - Phone:312-509-0785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty