Provider Demographics
NPI:1497926638
Name:HAAS, JOANNE CARRIE (MSW)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:CARRIE
Last Name:HAAS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 SHERMAN AVE
Mailing Address - Street 2:SUITE #305
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-3798
Mailing Address - Country:US
Mailing Address - Phone:857-733-9043
Mailing Address - Fax:
Practice Address - Street 1:1830 SHERMAN AVE
Practice Address - Street 2:SUITE #305
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3798
Practice Address - Country:US
Practice Address - Phone:857-733-9043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-16
Last Update Date:2008-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker