Provider Demographics
NPI:1811674682
Name:LAHORI, JASMINE LORRAINE (LSW)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:LORRAINE
Last Name:LAHORI
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:LORRAINE
Other - Middle Name:
Other - Last Name:LAHORI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSW
Mailing Address - Street 1:768 W JACKSON BLVD BLDG APT 323
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-5407
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1700 W IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-2559
Practice Address - Country:US
Practice Address - Phone:773-717-2040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.110251104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker