Provider Demographics
NPI:1477806495
Name:KAREGEANNES, NICHOLAS C (LCSW)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:C
Last Name:KAREGEANNES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2946 N ALBANY AVE
Mailing Address - Street 2:APT. #3W
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-7632
Mailing Address - Country:US
Mailing Address - Phone:773-517-1790
Mailing Address - Fax:
Practice Address - Street 1:2946 N ALBANY AVE
Practice Address - Street 2:APT. #3W
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-7632
Practice Address - Country:US
Practice Address - Phone:773-517-1790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490152591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical