Provider Demographics
NPI:1093108300
Name:HUTNER, ALLISON J (LCSW)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:J
Last Name:HUTNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:J
Other - Last Name:LIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1219 CAROLINE CT
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-4192
Mailing Address - Country:US
Mailing Address - Phone:224-217-2435
Mailing Address - Fax:
Practice Address - Street 1:1219 CAROLINE CT
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-4192
Practice Address - Country:US
Practice Address - Phone:224-217-2435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-11
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490112371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical