Provider Demographics
NPI:1962738922
Name:LURIE COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:LURIE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:REBECCA
Authorized Official - Last Name:LURIE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-573-3105
Mailing Address - Street 1:2105 LAVERS CIR
Mailing Address - Street 2:#507
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-7606
Mailing Address - Country:US
Mailing Address - Phone:561-573-3105
Mailing Address - Fax:
Practice Address - Street 1:2105 LAVERS CIR
Practice Address - Street 2:#507
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-7606
Practice Address - Country:US
Practice Address - Phone:561-573-3105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW93811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDINGOtherMEDICARE PENDING