Provider Demographics
NPI:1750405155
Name:DRAKE, LAURA SKALA (MA)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:SKALA
Last Name:DRAKE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3636 N JANSSEN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-3708
Mailing Address - Country:US
Mailing Address - Phone:312-953-1955
Mailing Address - Fax:
Practice Address - Street 1:3636 N JANSSEN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-3708
Practice Address - Country:US
Practice Address - Phone:312-953-1955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional