Provider Demographics
NPI:1639666746
Name:NOVAK, BRAD JEFFEREY (MA, LCPC)
Entity Type:Individual
Prefix:MR
First Name:BRAD
Middle Name:JEFFEREY
Last Name:NOVAK
Suffix:
Gender:M
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:333 N MICHIGAN AVE STE 1900
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-3994
Mailing Address - Country:US
Mailing Address - Phone:773-321-2768
Mailing Address - Fax:312-540-0944
Practice Address - Street 1:333 N MICHIGAN AVE STE 1900
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-3994
Practice Address - Country:US
Practice Address - Phone:773-321-2768
Practice Address - Fax:312-540-0944
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.011567101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health