Provider Demographics
NPI:1659842417
Name:KATHERINE FRUHAUFF, PSYD, INC.
Entity Type:Organization
Organization Name:KATHERINE FRUHAUFF, PSYD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRUHAUFF
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:224-408-0019
Mailing Address - Street 1:2138 BRUMMEL ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3608
Mailing Address - Country:US
Mailing Address - Phone:847-219-2615
Mailing Address - Fax:
Practice Address - Street 1:2530 CRAWFORD AVE STE 104
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4954
Practice Address - Country:US
Practice Address - Phone:224-408-0019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-05
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)