Provider Demographics
NPI:1407442015
Name:NOVAK, CATHALEEN L (LCSW)
Entity Type:Individual
Prefix:
First Name:CATHALEEN
Middle Name:L
Last Name:NOVAK
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 1:10540 S WESTERN AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-2529
Mailing Address - Country:US
Mailing Address - Phone:708-406-9248
Mailing Address - Fax:
Practice Address - Street 1:10540 S WESTERN AVE STE 208
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-2529
Practice Address - Country:US
Practice Address - Phone:708-406-9248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-17
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490165241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical