Provider Demographics
NPI:1033860226
Name:YOO, SCOTT (LCSW, CADC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:YOO
Suffix:
Gender:M
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1243 DA VINCI DR
Mailing Address - Street 2:
Mailing Address - City:HAMPSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60140-5600
Mailing Address - Country:US
Mailing Address - Phone:847-909-0918
Mailing Address - Fax:
Practice Address - Street 1:1616 E ROOSEVELT RD STE 8
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-6850
Practice Address - Country:US
Practice Address - Phone:630-588-1201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL35358101YA0400X
IL149.0239621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)