Provider Demographics
NPI:1275754434
Name:MOJICA, BEATRICE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BEATRICE
Middle Name:
Last Name:MOJICA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:BEATRICE
Other - Middle Name:
Other - Last Name:MOJICA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2539 N. MASON
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60639
Mailing Address - Country:US
Mailing Address - Phone:773-237-0777
Mailing Address - Fax:
Practice Address - Street 1:2354 N. MILWAUKEE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647
Practice Address - Country:US
Practice Address - Phone:312-744-0993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149007973101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL149007973OtherLCSW