Provider Demographics
NPI:1295835205
Name:CREEDON, VALERIE M (LCSW)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:M
Last Name:CREEDON
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 1:820 S DAMEN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3728
Mailing Address - Country:US
Mailing Address - Phone:773-545-1924
Mailing Address - Fax:312-569-6516
Practice Address - Street 1:820 S DAMEN AVE
Practice Address - Street 2:MS 11
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3728
Practice Address - Country:US
Practice Address - Phone:312-569-6516
Practice Address - Fax:312-569-6171
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490125151041C0700X
IL150010004104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker