Provider Demographics
NPI:1073175584
Name:GARNETT, TONIA RENEE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TONIA
Middle Name:RENEE
Last Name:GARNETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10336 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-2407
Mailing Address - Country:US
Mailing Address - Phone:708-634-6823
Mailing Address - Fax:
Practice Address - Street 1:10336 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-2407
Practice Address - Country:US
Practice Address - Phone:708-634-6823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-04
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1041781041C0700X
IL149.0214031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical