Provider Demographics
NPI:1497879282
Name:GREENBERG, GERI P (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:GERI
Middle Name:P
Last Name:GREENBERG
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 1:920 SUFFIELD TER
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-3014
Mailing Address - Country:US
Mailing Address - Phone:847-272-7747
Mailing Address - Fax:
Practice Address - Street 1:777 E ALGONQUIN RD
Practice Address - Street 2:COMMUNITY CONSOLIDATED SCHOOL DIST 62
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-6251
Practice Address - Country:US
Practice Address - Phone:847-824-1136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool