Provider Demographics
NPI:1124379003
Name:HAUSMANN, JEAN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:
Last Name:HAUSMANN
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 1:433 W BRIAR PL
Mailing Address - Street 2:APT 5C
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657
Mailing Address - Country:US
Mailing Address - Phone:401-871-6996
Mailing Address - Fax:
Practice Address - Street 1:433 W BRIAR PL APT 5C
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4762
Practice Address - Country:US
Practice Address - Phone:401-871-6996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW021891041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical