Provider Demographics
NPI:1477964138
Name:DAMES, SUSAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:DAMES
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 1:1441 BRANDING AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1160
Mailing Address - Country:US
Mailing Address - Phone:630-963-7900
Mailing Address - Fax:224-353-6328
Practice Address - Street 1:1441 BRANDING AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1160
Practice Address - Country:US
Practice Address - Phone:630-963-7900
Practice Address - Fax:224-353-6328
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490070351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical