| Lifespan Behavioral Health P.c. | |
|
2502 N Clark St Ste 212 Chicago IL 60614-1850 | |
| (773) 930-9553 | |
| Not Available |
| Full Name | Lifespan Behavioral Health P.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2502 N Clark St Ste 212, Chicago, Illinois |
| Authorized Official Name and Position | Matthew Harings (CEO) |
| Authorized Official Contact | 7739309553 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifespan Behavioral Health P.c. 2502 N Clark St Ste 212 Chicago IL 60614-1850 Ph: (773) 930-9553 | Lifespan Behavioral Health P.c. 2502 N Clark St Ste 212 Chicago IL 60614-1850 Ph: (773) 930-9553 |
| NPI Number | 1083299572 |
|---|---|
| Provider Enumeration Date | 03/16/2021 |
| Last Update Date | 07/29/2024 |
| Certification Date | 07/29/2024 |
| Medicare PECOS PAC ID | 4486057718 |
|---|---|
| Medicare Enrollment ID | O20210726000135 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083299572 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Matthew Harings |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679158430 PECOS PAC ID: 5395148621 Enrollment ID: I20210726000178 |
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