Provider Demographics
NPI:1063558625
Name:SILVERSTEIN, LOIS N (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:N
Last Name:SILVERSTEIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 CHURCH ST
Mailing Address - Street 2:SUITE 409
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4508
Mailing Address - Country:US
Mailing Address - Phone:847-475-8342
Mailing Address - Fax:847-432-7331
Practice Address - Street 1:636 CHURCH ST
Practice Address - Street 2:SUITE 409
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4508
Practice Address - Country:US
Practice Address - Phone:847-475-8342
Practice Address - Fax:847-432-7331
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.000461101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL929440Medicare ID - Type Unspecified
IL929441Medicare ID - Type Unspecified