Provider Demographics
NPI:1164138699
Name:WILL DEMPSEY, LICSW, LLC
Entity Type:Organization
Organization Name:WILL DEMPSEY, LICSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMPSEY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:617-237-6664
Mailing Address - Street 1:1328 W EDDY ST APT 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-8174
Mailing Address - Country:US
Mailing Address - Phone:617-237-6664
Mailing Address - Fax:
Practice Address - Street 1:332 S MICHIGAN AVE STE 121
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604-4302
Practice Address - Country:US
Practice Address - Phone:617-237-6664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)