Blalark, Ava Lavon

Blalark, Ava Lavon is an sole proprietor health care provider with primary practice located at 18W101 Standish Ln , Villa Park IL 60181-3644. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / School is her primary health care specialty. Blalark, Ava Lavon can be contacted via phone (773) 469-5499.

Contact Information

Primary practice address
18W101 Standish Ln Villa Park IL 60181-3644
Phone: (773) 469-5499
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 1041S0200X 2246775 Illinois
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149.017574 Illinois

Profile Details

NPI number 1831337807
LBN Legal business name Blalark, Ava Lavon
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 29th, 2009
Last updated Jul 25th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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