Provider Demographics
NPI:1629547781
Name:ASSOCIATES IN PSYCHOLOGICAL AND EDUCATIONAL SERVICES, LLC
Entity Type:Organization
Organization Name:ASSOCIATES IN PSYCHOLOGICAL AND EDUCATIONAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PROFESSIONAL COUN
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:GILBERT
Authorized Official - Last Name:GERBER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-997-7470
Mailing Address - Street 1:411 KELBURN RD APT 324
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4385
Mailing Address - Country:US
Mailing Address - Phone:847-997-7470
Mailing Address - Fax:
Practice Address - Street 1:85 REVERE DR STE B
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-8001
Practice Address - Country:US
Practice Address - Phone:224-261-8462
Practice Address - Fax:224-261-8463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL261QM0801XMedicaid