Provider Demographics
NPI:1548736812
Name:STEIN, ALLISON LENTULUS (MSW, LSW)
Entity Type:Individual
Prefix:MISS
First Name:ALLISON
Middle Name:LENTULUS
Last Name:STEIN
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:992 1/2 GREEN BAY RD
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:IL
Mailing Address - Zip Code:60093-1722
Mailing Address - Country:US
Mailing Address - Phone:847-446-8060
Mailing Address - Fax:
Practice Address - Street 1:992 1/2 GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093-1722
Practice Address - Country:US
Practice Address - Phone:847-446-8060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.101243104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker