Provider Demographics
NPI:1619419769
Name:THE SOCIAL SKILLS PLACE, INC.
Entity Type:Organization
Organization Name:THE SOCIAL SKILLS PLACE, INC.
Other - Org Name:SUSAN STERN, LCSW
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-507-8834
Mailing Address - Street 1:464 CENTRAL AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-3040
Mailing Address - Country:US
Mailing Address - Phone:847-446-7430
Mailing Address - Fax:847-446-7430
Practice Address - Street 1:464 CENTRAL AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-3040
Practice Address - Country:US
Practice Address - Phone:847-446-7430
Practice Address - Fax:847-446-7430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.012129251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health