Individual
DR. LORA VAN ARSDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD LCSW
Contact information
Practice address
5 REVERE DR STE 200, NORTHBROOK, IL 60062-8000
(630) 258-8059
(844) 629-5618
Mailing address
5 REVERE DRIVE, SUITE 200 PMD 2100, NORTHBROOK, IL 60062-1381
(630) 258-8059
(844) 629-5618
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071009542
IL
1041C0700X
Clinical Social Worker
149017112
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
F400378779
—
IL
Enumeration date
12/15/2014
Last updated
11/06/2018
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