Provider Demographics
NPI:1134273915
Name:SHEWNARAIN, MAYA (LCPC)
Entity type:Individual
Prefix:MS
First Name:MAYA
Middle Name:
Last Name:SHEWNARAIN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 W ESTES AVE
Mailing Address - Street 2:#203
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-2363
Mailing Address - Country:US
Mailing Address - Phone:847-334-0857
Mailing Address - Fax:
Practice Address - Street 1:1601 SHERMAN AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-5038
Practice Address - Country:US
Practice Address - Phone:847-334-0857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional