Provider Demographics
NPI:1912335431
Name:LORI DEMAIN, THERAPY SERVICES LTD
Entity Type:Organization
Organization Name:LORI DEMAIN, THERAPY SERVICES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW / OWNER / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMAIN BRADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:708-763-0225
Mailing Address - Street 1:1155 S. LOMBARD AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-2245
Mailing Address - Country:US
Mailing Address - Phone:708-763-0225
Mailing Address - Fax:708-763-0225
Practice Address - Street 1:1155 S. LOMBARD AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-2245
Practice Address - Country:US
Practice Address - Phone:708-763-0225
Practice Address - Fax:708-763-0225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-18
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490048581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty