Provider Demographics
NPI:1861973430
Name:LAHUE, GARTH WILLIAM (LMFT)
Entity type:Individual
Prefix:
First Name:GARTH
Middle Name:WILLIAM
Last Name:LAHUE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5866 N MEDINA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-5304
Mailing Address - Country:US
Mailing Address - Phone:262-822-2772
Mailing Address - Fax:
Practice Address - Street 1:30 N MICHIGAN AVE STE 809
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3776
Practice Address - Country:US
Practice Address - Phone:312-767-2057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-22
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1801273446Medicaid