NPI 1639623044 · live from the CMS NPI Registry
A Promise For Parents
Social Worker, Clinical in Dekalb, IL. National Provider Identifier 1639623044, active.
NPI record
| NPI | 1639623044 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 810 S 4th St, Dekalb, IL 60115 |
| Practice phone | 815-758-1358 |
| Enumerated | August 15, 2016 |
| Last updated | August 15, 2016 |
| Authorized official | Denice Mock, Director/Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical primary | 1041C0700X | 149013457 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.