Provider Demographics
NPI:1780816900
Name:MCLAUGHLIN, BRIAN ROBERT (LMFT)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:ROBERT
Last Name:MCLAUGHLIN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2521 N TALMAN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-1811
Mailing Address - Country:US
Mailing Address - Phone:773-865-6455
Mailing Address - Fax:773-278-7456
Practice Address - Street 1:2825 W MCLEAN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-6431
Practice Address - Country:US
Practice Address - Phone:773-865-6455
Practice Address - Fax:773-278-2456
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-21
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042617A103TC0700X
IL166.000724106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist