Provider Demographics
NPI:1255463519
Name:PRUJAN, ABBEY (LCPC, CADC)
Entity type:Individual
Prefix:
First Name:ABBEY
Middle Name:
Last Name:PRUJAN
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 OAK AVE
Mailing Address - Street 2:SUITE 203-N
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-3642
Mailing Address - Country:US
Mailing Address - Phone:847-733-7822
Mailing Address - Fax:847-491-0309
Practice Address - Street 1:1840 OAK AVE
Practice Address - Street 2:SUITE 203-N
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3642
Practice Address - Country:US
Practice Address - Phone:847-733-7822
Practice Address - Fax:847-491-0309
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL21062101YA0400X
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health