Provider Demographics
NPI:1366014805
Name:FORWARD THINKING THERAPY, LTD
Entity type:Organization
Organization Name:FORWARD THINKING THERAPY, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAAKE DEVLIEGER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:815-269-5002
Mailing Address - Street 1:303 E HILLCREST DR STE 3
Mailing Address - Street 2:
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-2476
Mailing Address - Country:US
Mailing Address - Phone:815-269-5007
Mailing Address - Fax:
Practice Address - Street 1:303 E HILLCREST DR STE 3
Practice Address - Street 2:
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-2476
Practice Address - Country:US
Practice Address - Phone:815-269-5007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty