Provider Demographics
NPI:1124261060
Name:JUSTIN TOBIN. LCSW
Entity type:Organization
Organization Name:JUSTIN TOBIN. LCSW
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:TOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:312-346-5156
Mailing Address - Street 1:180 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 916
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7401
Mailing Address - Country:US
Mailing Address - Phone:312-346-5156
Mailing Address - Fax:312-284-6088
Practice Address - Street 1:180 N MICHIGAN AVE
Practice Address - Street 2:SUITE 916
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7401
Practice Address - Country:US
Practice Address - Phone:312-346-5156
Practice Address - Fax:312-284-6088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-08
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty