Provider Demographics
NPI:1336787662
Name:MEIRA KATZOFF LCSW, LLC
Entity Type:Organization
Organization Name:MEIRA KATZOFF LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEIRA
Authorized Official - Middle Name:YAEL
Authorized Official - Last Name:KATZOFF
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-410-9129
Mailing Address - Street 1:9043 FORESTVIEW RD
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60203-1912
Mailing Address - Country:US
Mailing Address - Phone:414-698-8525
Mailing Address - Fax:
Practice Address - Street 1:4905 OLD ORCHARD CTR STE 510
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-4736
Practice Address - Country:US
Practice Address - Phone:847-410-9129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)