Provider Demographics
NPI:1558036731
Name:BARRATT, HOLLY ANNE (LSW)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:ANNE
Last Name:BARRATT
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 N LAKE SHORE DR APT 7J
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-6617
Mailing Address - Country:US
Mailing Address - Phone:815-261-8013
Mailing Address - Fax:
Practice Address - Street 1:2625 W TOUHY AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-3186
Practice Address - Country:US
Practice Address - Phone:773-973-5333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150104897104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker