Provider Demographics
NPI:1205408069
Name:SCHOFIELD, COLIN B (LCSW)
Entity Type:Individual
Prefix:MR
First Name:COLIN
Middle Name:B
Last Name:SCHOFIELD
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 1:556 S FAIRFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-2828
Mailing Address - Country:US
Mailing Address - Phone:708-799-8384
Mailing Address - Fax:708-799-1305
Practice Address - Street 1:10745 165TH ST
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-8713
Practice Address - Country:US
Practice Address - Phone:708-799-8384
Practice Address - Fax:708-799-1305
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149020242101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health