Provider Demographics
NPI:1164848438
Name:SENTER, CONNIE HARRIS (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CONNIE
Middle Name:HARRIS
Last Name:SENTER
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 1:3616 PARTHENON WAY
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1322
Mailing Address - Country:US
Mailing Address - Phone:708-747-1322
Mailing Address - Fax:
Practice Address - Street 1:3612 LINCOLN HWY
Practice Address - Street 2:SUITE 4
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1627
Practice Address - Country:US
Practice Address - Phone:708-747-1322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0029571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical