Provider Demographics
NPI:1437573102
Name:HUMAN, ADELE (LCSW)
Entity Type:Individual
Prefix:
First Name:ADELE
Middle Name:
Last Name:HUMAN
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 1:203 N OTTAWA ST
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60432-4006
Mailing Address - Country:US
Mailing Address - Phone:815-730-4891
Mailing Address - Fax:815-730-4918
Practice Address - Street 1:698 N LOCUST ST
Practice Address - Street 2:
Practice Address - City:MANTENO
Practice Address - State:IL
Practice Address - Zip Code:60950-1229
Practice Address - Country:US
Practice Address - Phone:800-240-7011
Practice Address - Fax:815-730-4918
Is Sole Proprietor?:No
Enumeration Date:2014-02-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0099721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical