Provider Demographics
NPI:1427811660
Name:CENTERED: NORTHSHORE CENTER FOR MENTAL HEALTH LLC
Entity type:Organization
Organization Name:CENTERED: NORTHSHORE CENTER FOR MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATELYN
Authorized Official - Middle Name:S
Authorized Official - Last Name:VARHELY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-334-3478
Mailing Address - Street 1:114 KEDZIE ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-2510
Mailing Address - Country:US
Mailing Address - Phone:847-334-3478
Mailing Address - Fax:
Practice Address - Street 1:114 KEDZIE ST
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-2510
Practice Address - Country:US
Practice Address - Phone:847-334-3478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty