Provider Demographics
NPI:1124128731
Name:STRAIN, TANI R (MA, LMFT)
Entity type:Individual
Prefix:
First Name:TANI
Middle Name:R
Last Name:STRAIN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 1ST ST
Mailing Address - Street 2:STE 403
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-3144
Mailing Address - Country:US
Mailing Address - Phone:847-433-8230
Mailing Address - Fax:847-433-8230
Practice Address - Street 1:1910 1ST ST
Practice Address - Street 2:STE 403
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-3144
Practice Address - Country:US
Practice Address - Phone:847-433-8230
Practice Address - Fax:847-433-8230
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001632519OtherBCBS