Provider Demographics
NPI:1417692906
Name:WOODS, DAZERIE SHAREE (BS, MSW, LSW)
Entity Type:Individual
Prefix:MS
First Name:DAZERIE
Middle Name:SHAREE
Last Name:WOODS
Suffix:
Gender:F
Credentials:BS, MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 LASSER DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-5406
Mailing Address - Country:US
Mailing Address - Phone:630-219-8312
Mailing Address - Fax:
Practice Address - Street 1:1412 LASSER DR
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586-5406
Practice Address - Country:US
Practice Address - Phone:630-219-8312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker