Provider Demographics
NPI:1255501680
Name:HASSENFELD, KIMBERLY SLOAN (LCSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:SLOAN
Last Name:HASSENFELD
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 1:2267 N KEDZIE BLVD # 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-2561
Mailing Address - Country:US
Mailing Address - Phone:773-862-2052
Mailing Address - Fax:
Practice Address - Street 1:1608 N MILWAUKEE AVE
Practice Address - Street 2:SUITE 709
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-5456
Practice Address - Country:US
Practice Address - Phone:773-531-6808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0125521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical