CENTER FOR GRIEF AND TRAUMATIC LOSS, LLC (NPI# 1366655813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366655813 |
| Entity Type | Organization |
| Organization Name | CENTER FOR GRIEF AND TRAUMATIC LOSS, LLC |
| Practice Address |
1144 Harms Ave Libertyville IL 60048-2524 |
| Practice Telephone | 8476800279 |
| Mailing Telephone | 8476800279 |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ALLAN L. BOTKIN (DIRECTOR) |
| Authorized Official Telephone | 8476800279 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
IL | Behavioral Health & Social Service Providers |
| Street Address |
1144 HARMS AVE |
| City | LIBERTYVILLE |
| State | IL |
| Zip Code | 60048-2524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639382252 | Allan L. Botkin | Psychologist | 1144 Harms Ave, Libertyville, IL 60048-2524 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184119950 | Park Avenue Dental Professionals, PC | Dentist | 1001 W. Park Avenue, Libertyville, IL 60048 | 2018-06-25 |
| 1437643525 | Shanna Coyle | Registered Nurse | 1128 Jaimee Ln, Libertyville, IL 60048 | 2018-06-21 |
| 1366943672 | Jackie Rayyan | Behavior Technician | 917 Sherwood Drive, Suite 201, Lake Bluff, IL 60048 | 2018-02-22 |
| 1851804850 | Mary E. Linsey | Counselor | 34180 Highway 45, Libertyville, IL 60048 | 2017-11-13 |
| 1962929018 | Affinity Integrated Healthcare | Chiropractor | 736 Florsheim Dr, St 12, Libertyville, IL 60048 | 2017-08-29 |
| 1164946471 | Christianna Patterson | Speech-Language Pathologist | 1870 W Winchester Rd #203, Libertyville, IL 60048 | 2017-07-28 |
| 1962938407 | Kyle Winiger | Specialist/Technologist | 4551 West Gavin Lane, Libertyville, IL 60048 | 2017-05-03 |
| 1396291530 | Karyn Kolner | Physical Therapist | 860 W Winchester Rd, #108, Libertyville, IL 60048 | 2016-08-28 |
| 1477900785 | Medlogic LLC | Clinic/Center | 114 West Rockland Road, Suite 201, Libertyville, IL 60048 | 2016-05-17 |
| 1477926343 | Robert Mcnulty | Student in an Organized Health Care Education/Training Program | 1313 Crane Blvd, Libertyville, IL 60048 | 2015-11-02 |
| Find all providers in zip 60048 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730504226 | Calm Minds LLC | Psychologist | 1590 S Milwaukee Ave Ste 201, Libertyville, IL 60048-3797 | 2014-02-20 |
| 1942576004 | Aimee Rodolff | Psychologist | 1580 S Milwaukee Ave Ste 202, Libertyville, IL 60048-3772 | 2012-03-22 |
| 1134424146 | Kevin C. Murphy | Psychologist | 112 N Milwaukee Ave, Suite A3, Libertyville, IL 60048-2234 | 2011-01-21 |
| 1083789945 | Deanna Isabel Lulofs | Psychologist | 1641 N Milwaukee Ave St #7, Adler Park Plaza, Libertyville, IL 60048-1350 | 2006-11-22 |
| 1881783389 | Frances J Pacheco | Psychologist | 1641 N Milwaukee Ave Ste 7, Libertyville, IL 60048-1350 | 2006-10-12 |
| 1205936952 | Marylou Nallen | Psychologist | 708 Florsheim Dr, Suite 13, Libertyville, IL 60048-5001 | 2006-09-23 |
| 1760408488 | Margaret Pechota | Psychologist | 128 Newberry Ave, Libertyville, IL 60048-1923 | 2006-07-14 |
| 1679196588 | Mental Health Revolution LLC | Psychologist | 1580 S Milwaukee Ave Ste 202, Libertyville, IL 60048-3772 | 2020-05-26 |
| 1245782754 | Connect Psychological Services | Psychologist | 1580 S Milwaukee Ave, Suite 407, Libertyville, IL 60048-3764 | 2016-10-31 |
| 1407243918 | Wiegand Psychological Services, LLC | Psychologist | 1248 American Way, Libertyville, IL 60048-3936 | 2015-04-22 |
| Find all providers in LIBERTYVILLE | ||||
| City | LIBERTYVILLE |
| Zip Code | 60048 |
Please comment or provide details below to improve the information on CENTER FOR GRIEF AND TRAUMATIC LOSS, LLC.
| 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.