Provider Demographics
NPI:1619699287
Name:NORTHSTAR THERAPY IN NORTHBROOK
Entity Type:Organization
Organization Name:NORTHSTAR THERAPY IN NORTHBROOK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAITLYN
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:DOLINS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:815-276-1224
Mailing Address - Street 1:1021 N WOOD ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-4349
Mailing Address - Country:US
Mailing Address - Phone:815-276-1224
Mailing Address - Fax:
Practice Address - Street 1:1021 N WOOD ST APT 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-4349
Practice Address - Country:US
Practice Address - Phone:815-276-1224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty