Provider Demographics
NPI:1275256661
Name:GRIZZELL, DEBORAH JENSON (MSSW, LCSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:JENSON
Last Name:GRIZZELL
Suffix:
Gender:F
Credentials:MSSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2713 TROJAK LN
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-8891
Mailing Address - Country:US
Mailing Address - Phone:630-292-7092
Mailing Address - Fax:
Practice Address - Street 1:121 N WASHINGTON ST STE 25
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-4558
Practice Address - Country:US
Practice Address - Phone:630-358-9482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0248661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical