Provider Demographics
NPI:1518308808
Name:SINGER, JULIA GORDON (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:GORDON
Last Name:SINGER
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 1:2855 W JEROME ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-1230
Mailing Address - Country:US
Mailing Address - Phone:773-274-2478
Mailing Address - Fax:
Practice Address - Street 1:2855 W JEROME ST
Practice Address - Street 2:2855 W. JEROME ST.
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-1230
Practice Address - Country:US
Practice Address - Phone:773-274-2478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL16638601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical