Provider Demographics
NPI:1164690566
Name:JAMES, TRICIA G (LCSW)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:G
Last Name:JAMES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:TRICIA
Other - Middle Name:G
Other - Last Name:JAMES-EDELSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2631 FAIRFAX LN
Mailing Address - Street 2:
Mailing Address - City:LAKE IN THE HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60156-6321
Mailing Address - Country:US
Mailing Address - Phone:312-218-4215
Mailing Address - Fax:
Practice Address - Street 1:2631 FAIRFAX LN
Practice Address - Street 2:
Practice Address - City:LAKE IN THE HILLS
Practice Address - State:IL
Practice Address - Zip Code:60156-6321
Practice Address - Country:US
Practice Address - Phone:312-218-4215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-19
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0123271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical