Gudvangen, Lori

Gudvangen, Lori is an sole proprietor health care provider with primary practice located at 420 S 1St St , West Dundee IL 60118-2902. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Gudvangen, Lori can be contacted via phone (847) 531-0216.

Contact Information

Primary practice address
420 S 1St St West Dundee IL 60118-2902
Phone: (847) 531-0216
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149015924 Illinois

Profile Details

NPI number 1194108738
LBN Legal business name Gudvangen, Lori
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 1st, 2015
Last updated Aug 2nd, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194108738 NPPES
Washington MEDICAID 2071366

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