Provider Demographics
NPI:1407901788
Name:WISNIEWSKI, JOYCE K (LCSW)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:K
Last Name:WISNIEWSKI
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 1:463 PINEWOODS DR
Mailing Address - Street 2:
Mailing Address - City:NORTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-2227
Mailing Address - Country:US
Mailing Address - Phone:847-381-6191
Mailing Address - Fax:847-381-9253
Practice Address - Street 1:836 S NORTHWEST HWY
Practice Address - Street 2:SUITE H
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-6326
Practice Address - Country:US
Practice Address - Phone:847-381-4981
Practice Address - Fax:847-381-4997
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical