Provider Demographics
NPI:1225324585
Name:NINNEMANN, JUNE C (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JUNE
Middle Name:C
Last Name:NINNEMANN
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 1:6009 N NINA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-2411
Mailing Address - Country:US
Mailing Address - Phone:773-631-5673
Mailing Address - Fax:773-631-2275
Practice Address - Street 1:6009 N NINA AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-2411
Practice Address - Country:US
Practice Address - Phone:773-631-5673
Practice Address - Fax:773-631-2275
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490018431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical