Provider Demographics
NPI:1801054515
Name:ILIEVSKI, DRAGA (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:DRAGA
Middle Name:
Last Name:ILIEVSKI
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WASHINGTON ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-4768
Mailing Address - Country:US
Mailing Address - Phone:219-464-8811
Mailing Address - Fax:
Practice Address - Street 1:5 WASHINGTON ST
Practice Address - Street 2:SUITE 250
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-4768
Practice Address - Country:US
Practice Address - Phone:219-464-8811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2016-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004858A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical