Provider Demographics
NPI:1356633051
Name:DEAN, REBECCA H (LCSW)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:H
Last Name:DEAN
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 1:501 E 32ND ST APT 2215
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-4085
Mailing Address - Country:US
Mailing Address - Phone:312-504-8383
Mailing Address - Fax:
Practice Address - Street 1:501 E 32ND ST APT 2215
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-4085
Practice Address - Country:US
Practice Address - Phone:312-504-8383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490088051041C0700X
IL16015971041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool