Provider Demographics
NPI:1053756114
Name:HYDARI, NOSHEEN H (MS MFT, LMFT)
Entity type:Individual
Prefix:
First Name:NOSHEEN
Middle Name:H
Last Name:HYDARI
Suffix:
Gender:F
Credentials:MS MFT, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2322 W AUGUSTA BLVD APT 3B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-4872
Mailing Address - Country:US
Mailing Address - Phone:630-965-6674
Mailing Address - Fax:
Practice Address - Street 1:2322 W AUGUSTA BLVD APT 3B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-4872
Practice Address - Country:US
Practice Address - Phone:630-965-6674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208.000302106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist