Provider Demographics
NPI:1851942155
Name:KAUR, PRABHDEEP (LCSW)
Entity type:Individual
Prefix:
First Name:PRABHDEEP
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 FOUNDERS POINTE N
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-1458
Mailing Address - Country:US
Mailing Address - Phone:630-977-9024
Mailing Address - Fax:
Practice Address - Street 1:745 MCCLINTOCK DR STE 100
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-0863
Practice Address - Country:US
Practice Address - Phone:630-491-6846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-27
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490164961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical