Provider Demographics
NPI:1134308406
Name:SHOLEMSON, JEFFREY HOWARD (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:HOWARD
Last Name:SHOLEMSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9669 KENTON AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1227
Mailing Address - Country:US
Mailing Address - Phone:847-425-6400
Mailing Address - Fax:847-425-6408
Practice Address - Street 1:9669 KENTON AVE STE 204
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1227
Practice Address - Country:US
Practice Address - Phone:847-425-6400
Practice Address - Fax:847-425-6408
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-02
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0119821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical