Provider Demographics
NPI:1174937098
Name:HEBEKA, GENEVIEVE ROSE (LCSW)
Entity type:Individual
Prefix:MS
First Name:GENEVIEVE
Middle Name:ROSE
Last Name:HEBEKA
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 1:320 BEATRICE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-4344
Mailing Address - Country:US
Mailing Address - Phone:773-633-3086
Mailing Address - Fax:
Practice Address - Street 1:320 BEATRICE AVE
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-4344
Practice Address - Country:US
Practice Address - Phone:773-633-3086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149 0112611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical