Organization
LEEP FORWARD, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORELL MARIN M.ED., LCSW, BCBA (CVO/OWNER)
(312) 624-8750
Entity
Organization
Contact information
Practice address
1447 W MONTROSE AVE, CHICAGO, IL 60613-1348
(312) 624-8750
Mailing address
1447 W MONTROSE AVE, CHICAGO, IL 60613-1348
(312) 624-8750
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
01/18/2012
Last updated
03/17/2026
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