Provider Demographics
NPI:1588179386
Name:TRIUMPH SEMINARS
Entity Type:Organization
Organization Name:TRIUMPH SEMINARS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AUDREA
Authorized Official - Middle Name:FUMBANKS
Authorized Official - Last Name:NANABRAY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW
Authorized Official - Phone:630-825-9673
Mailing Address - Street 1:1310 W 64TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60636-2913
Mailing Address - Country:US
Mailing Address - Phone:773-912-6967
Mailing Address - Fax:844-492-3952
Practice Address - Street 1:1310 W 64TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60636-2913
Practice Address - Country:US
Practice Address - Phone:773-912-6967
Practice Address - Fax:844-492-3952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-04
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0190561041C0700X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty