Provider Demographics
NPI:1508380486
Name:WEINBERG, CALLIE (LCSW)
Entity Type:Individual
Prefix:
First Name:CALLIE
Middle Name:
Last Name:WEINBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CALLIE
Other - Middle Name:
Other - Last Name:GRADY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2945 N DAMEN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-8251
Mailing Address - Country:US
Mailing Address - Phone:217-855-9539
Mailing Address - Fax:
Practice Address - Street 1:2945 N DAMEN AVE
Practice Address - Street 2:1S
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618
Practice Address - Country:US
Practice Address - Phone:217-855-9539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0166881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical