Provider Demographics
NPI:1225351166
Name:TROOB, JULIE (LCSW, ACHT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:TROOB
Suffix:
Gender:F
Credentials:LCSW, ACHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 W DIVERSEY PKWY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1669
Mailing Address - Country:US
Mailing Address - Phone:773-540-8306
Mailing Address - Fax:
Practice Address - Street 1:561 W DIVERSEY PKWY
Practice Address - Street 2:SUITE 216
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-6068
Practice Address - Country:US
Practice Address - Phone:773-540-8306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-06
Last Update Date:2011-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0136051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical