Provider Demographics
NPI:1295809986
Name:CORRI FERDMAN LCSW LLC
Entity type:Organization
Organization Name:CORRI FERDMAN LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:MISS
Authorized Official - First Name:CORRI
Authorized Official - Middle Name:J
Authorized Official - Last Name:FERDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-793-0788
Mailing Address - Street 1:120 W EASTMAN ST
Mailing Address - Street 2:301
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-5937
Mailing Address - Country:US
Mailing Address - Phone:847-793-0788
Mailing Address - Fax:847-793-0789
Practice Address - Street 1:900 NORTH SHORE DR
Practice Address - Street 2:200
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044-2243
Practice Address - Country:US
Practice Address - Phone:847-793-0788
Practice Address - Fax:847-793-0789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4932415OtherBLUE CROSS BLUE SHIELD
IL=========OtherVALUE OPTIONS
IL=========OtherLIFE SYNCH
IL=========OtherCIGNA
IL=========OtherPHCS
IL=========OtherFIRST HEALTH / COVENTRY
IL=========OtherAETNA
IL=========OtherHUMANA
IL=========OtherMAGELLAN
IL=========OtherUNITED BEHAVIORAL HEALTH
IL4932415OtherBLUE CROSS BLUE SHIELD
IL=========OtherUNITED HEALTH CARE