Provider Demographics
NPI:1487121158
Name:FIRESTEIN, ORLI RACHEL (LCSW)
Entity type:Individual
Prefix:
First Name:ORLI
Middle Name:RACHEL
Last Name:FIRESTEIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ORLI
Other - Middle Name:RACHEL
Other - Last Name:GINSBURG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1338 W BIRCHWOOD AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-7193
Mailing Address - Country:US
Mailing Address - Phone:773-340-0047
Mailing Address - Fax:
Practice Address - Street 1:1338 W BIRCHWOOD AVE APT 3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-7193
Practice Address - Country:US
Practice Address - Phone:773-340-0047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-30
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL23209851041S0200X
IL149.0197831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool