Provider Demographics
NPI:1366782989
Name:DANA PLOUS LCSW LLC
Entity type:Organization
Organization Name:DANA PLOUS LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLOUS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:312-545-9212
Mailing Address - Street 1:1636 N WELLS ST
Mailing Address - Street 2:#1707
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-6037
Mailing Address - Country:US
Mailing Address - Phone:312-545-9212
Mailing Address - Fax:
Practice Address - Street 1:790 W FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-1204
Practice Address - Country:US
Practice Address - Phone:312-545-9212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-19
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490130471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty