Organization
LAKESHORE CENTER FOR BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. C ALAN EAKS (CEO)
(773) 907-4600
Entity
Organization
Contact information
Practice address
737 N MICHIGAN AVE, SUITE 1520, CHICAGO, IL 60611-2615
(773) 907-4600
(773) 907-4607
Mailing address
4840 N MARINE DR, CHICAGO, IL 60640-7860
(773) 907-4600
(773) 907-4607
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TF0200X
Forensic Psychologist
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
04/16/2012
Last updated
04/16/2012
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