Provider Demographics
NPI:1184450843
Name:NAMASA THERAPY, LLC
Entity type:Organization
Organization Name:NAMASA THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DENNISE
Authorized Official - Middle Name:SERUR
Authorized Official - Last Name:DEMITRO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:630-917-0552
Mailing Address - Street 1:250 WESTHAVEN CIR
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-3971
Mailing Address - Country:US
Mailing Address - Phone:630-917-0552
Mailing Address - Fax:
Practice Address - Street 1:250 WESTHAVEN CIR
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-3971
Practice Address - Country:US
Practice Address - Phone:630-917-0552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-10
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health