Provider Demographics
NPI:1306667670
Name:CHARNOV, ALI (LPC)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:CHARNOV
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1823 N HALSTED ST APT 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-6924
Mailing Address - Country:US
Mailing Address - Phone:847-987-2542
Mailing Address - Fax:
Practice Address - Street 1:191 WAUKEGAN RD STE 115
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-2743
Practice Address - Country:US
Practice Address - Phone:847-201-4278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178019665101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional