Provider Demographics
NPI:1790383610
Name:JONI LAMB THERAPY, LLC
Entity Type:Organization
Organization Name:JONI LAMB THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LCSW
Authorized Official - Prefix:MS
Authorized Official - First Name:JONI
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-450-6727
Mailing Address - Street 1:1555 SHERMAN AVE # 308
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4421
Mailing Address - Country:US
Mailing Address - Phone:847-450-6727
Mailing Address - Fax:
Practice Address - Street 1:1555 SHERMAN AVE # 308
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4421
Practice Address - Country:US
Practice Address - Phone:847-450-6727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1568517076OtherNPI 1