Organization
LAUREN SENOFF, LCSW SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAUREN DEE SENOFF LCSW (CLINICAL SOCIAL WORKER)
(217) 359-4066
Entity
Organization
Contact information
Practice address
206 N RANDOLPH ST, 9, CHAMPAIGN, IL 61820-3949
(217) 359-4066
Mailing address
206 N RANDOLPH ST STE 9, CHAMPAIGN, IL 61820-3976
(217) 359-4066
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
149002453
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609947928
NPI
IL
Enumeration date
11/21/2016
Last updated
11/21/2016
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