Provider Demographics
NPI:1922194323
Name:ORENSTEIN, MYRNA (PHD LCSW)
Entity Type:Individual
Prefix:DR
First Name:MYRNA
Middle Name:
Last Name:ORENSTEIN
Suffix:
Gender:F
Credentials:PHD LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 LEE ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-1713
Mailing Address - Country:US
Mailing Address - Phone:847-328-3060
Mailing Address - Fax:847-328-3144
Practice Address - Street 1:913 LEE ST
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-1713
Practice Address - Country:US
Practice Address - Phone:847-328-3060
Practice Address - Fax:847-328-3144
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0005594452OtherAETNA INSURANCE
IL9378216OtherPHCS
IL01632611OtherBLUE CROSS
IL0005594452OtherAETNA INSURANCE