Provider Demographics
NPI:1265661623
Name:MOSES, HELENE (LCSW)
Entity Type:Individual
Prefix:
First Name:HELENE
Middle Name:
Last Name:MOSES
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 1:900 CHICAGO AVE UNIT 407
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-1885
Mailing Address - Country:US
Mailing Address - Phone:847-271-8100
Mailing Address - Fax:
Practice Address - Street 1:909 DAVIS ST STE 160
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3664
Practice Address - Country:US
Practice Address - Phone:847-425-6415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-07
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490033091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical