Individual
LAWRENCE JAMES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-005555
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001625752
BCBS PROV. NO
IL
01
—
113311355
UNITED BEH HEALTH PROV.
IL
01
—
346545000
MAGELLAN PROVIDER NO
IL
Enumeration date
10/10/2006
Last updated
02/14/2017
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