Provider Demographics
NPI:1992271035
Name:VARMA, ANKUR (LCPC)
Entity type:Individual
Prefix:
First Name:ANKUR
Middle Name:
Last Name:VARMA
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 S OAKLEY AVE UNIT 406
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-4946
Mailing Address - Country:US
Mailing Address - Phone:513-376-0434
Mailing Address - Fax:
Practice Address - Street 1:180 N MICHIGAN AVE STE 410
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7488
Practice Address - Country:US
Practice Address - Phone:513-376-0434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.011252101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional