Provider Demographics
NPI:1417146671
Name:FARINAS, FRA ANGELICA S (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:FRA ANGELICA
Middle Name:S
Last Name:FARINAS
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 1:6456 N MOZART ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-5224
Mailing Address - Country:US
Mailing Address - Phone:773-615-1598
Mailing Address - Fax:
Practice Address - Street 1:1345 N ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-7391
Practice Address - Country:US
Practice Address - Phone:773-615-1598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health