Provider Demographics
NPI:1184771628
Name:GARBER AMRAM, LAURIE DENISE (LCSW)
Entity type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:DENISE
Last Name:GARBER AMRAM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LAURIE
Other - Middle Name:DENISE
Other - Last Name:GARBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:720 ALICE DRIVE
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062
Mailing Address - Country:US
Mailing Address - Phone:847-564-5110
Mailing Address - Fax:847-564-8077
Practice Address - Street 1:3400 DUNDEE ROAD
Practice Address - Street 2:SUITE 370
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062
Practice Address - Country:US
Practice Address - Phone:847-564-5110
Practice Address - Fax:847-564-8077
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
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
IL0001625563OtherBCBS