MARTIN SRAJEK, PHD., LCSW, LTD (NPI# 1154955037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154955037 |
| Entity Type | Organization |
| Organization Name | MARTIN SRAJEK, PHD., LCSW, LTD |
| Practice Address |
206 N Randolph St Ste 534-36 Champaign IL 61820-3949 |
| Practice Telephone | 2176372138 |
| Practice Fax Number | 2173554911 |
| Mailing Telephone | 2176372138 |
| Mailing Fax Number | 2173554911 |
| Enumeration Date | 2020-02-28 |
| Last Update Date | 2020-02-28 |
| Authorized Official Name | DR. MARTIN SRAJEK (DIRECTOR) |
| Authorized Official Telephone | 2176372138 |
| Authorized Official Credential | PHD, LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | INDIVIDUAL NPI | 1730392481 | 01 |
| IL | DRIVERS LICENSE | S622-5686-1037 | 01 |
| Street Address |
206 N RANDOLPH ST STE 534-36 |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61820-3949 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982217345 | Costco Wholesale Corporation | Pharmacy | 2002 N. Neil St., Champaign, IL 61820 | 2020-08-26 |
| 1255963583 | Jamey Richard Bailey | Social Worker | 701 Devonshire Drive, Bldg C, Suite 206, C-6, Champaign, IL 61820 | 2020-02-05 |
| 1790247443 | Jason Abrams | Counselor | 201 W Springfield Ave., Suite 1002-1003, Champaign, IL 61820 | 2019-04-02 |
| 1184100273 | Janine Rafferty | Pharmacist | 2002 N Neil St, Champaign, IL 61820 | 2018-07-12 |
| 1417475070 | Brodbeck Counseling, PC | Community/Behavioral Health | 301 N. Neil Street Suite 323, Champaign, IL 61820 | 2017-09-05 |
| 1447773726 | Quanata M Pelmore | Nurse's Aide | 508 E. Vine St, Champaign, IL 61820 | 2017-07-19 |
| 1821518127 | Molly Mclay | Social Worker | 309 W Clark St., Champaign, IL 61820 | 2017-06-27 |
| 1396265849 | Lou Echols Chambers | Audiologist | 901 South Sixth Street, Chamapign, IL 61820 | 2017-06-26 |
| 1962874495 | Luciana Angelica Guardini | Social Worker | 100 North Chestnut Street, Suite 244, Champaign, IL 61820 | 2015-10-23 |
| 1538544465 | Cpo Services, Inc. | Prosthetic/Orthotic Supplier | 410 E University Ave Ste 105, Champaign, IL 61820 | 2015-07-21 |
| Find all providers in zip 61820 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467772160 | Lutheran Social Services of Il | Clinic/Center | 103 S Country Fair Dr, Champaign, IL 61821-3061 | 2010-06-03 |
| 1619124302 | Community Elements, Inc. | Clinic/Center | 801 N Walnut St, Champaign, IL 61820-3055 | 2008-08-25 |
| 1093962961 | Community Elements, Inc | Clinic/Center | 614 W Healey St, Champaign, IL 61820-5025 | 2008-08-22 |
| 1831167337 | Community Elements Inc | Clinic/Center | 1801 Fox Dr, Champaign, IL 61820-7236 | 2006-03-09 |
| 1669084877 | Coles County Mental Health Association, Inc. | Clinic/Center | 1701 S Prospect Ave Ste 205, Champaign, IL 61820-7054 | 2020-08-19 |
| 1174084677 | Family Service of Champaign County | Clinic/Center | 405 S State St, Champaign, IL 61820-5129 | 2019-03-27 |
| 1083104558 | Rosecrance, Inc. | Clinic/Center | 2302 Moreland Blvd, Champaign, IL 61822-1398 | 2018-05-10 |
| 1902311442 | Rosecrance, Inc. | Clinic/Center | 122 W Hill St, Champaign, IL 61820-3519 | 2017-12-06 |
| 1871047209 | Cunningham Children's Home of Urbana Il | Clinic/Center | 701 Devonshire Dr, Champaign, IL 61820-7337 | 2016-08-15 |
| 1427406859 | Rosecrance Inc | Clinic/Center | 1801 Fox Dr, Champaign, IL 61820 | 2016-05-26 |
| Find all providers in CHAMPAIGN | ||||
Please comment or provide details below to improve the information on MARTIN SRAJEK, PHD., LCSW, LTD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.