Provider Demographics
NPI:1477141604
Name:MILTON, NICOLA C (LCSW)
Entity Type:Individual
Prefix:
First Name:NICOLA
Middle Name:C
Last Name:MILTON
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 1:10012 MOODY AVE
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-3722
Mailing Address - Country:US
Mailing Address - Phone:773-556-7481
Mailing Address - Fax:
Practice Address - Street 1:235 E 103RD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60628-2807
Practice Address - Country:US
Practice Address - Phone:773-371-3646
Practice Address - Fax:773-371-3699
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-04
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0228261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical