Provider Demographics
NPI:1699954883
Name:TASEFF, GEORGE ROBERT (MA, LCPC)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:ROBERT
Last Name:TASEFF
Suffix:
Gender:M
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 N WINDSOR DR
Mailing Address - Street 2:UNIT 201
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-2745
Mailing Address - Country:US
Mailing Address - Phone:847-875-5422
Mailing Address - Fax:
Practice Address - Street 1:2640 N WINDSOR DR
Practice Address - Street 2:UNIT 201
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-2745
Practice Address - Country:US
Practice Address - Phone:847-875-5422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008755101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional