Provider Demographics
NPI:1578602173
Name:GRIFFIN O'SULLIVAN, JOAN LYNN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:LYNN
Last Name:GRIFFIN O'SULLIVAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11938 STERLING DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-1420
Mailing Address - Country:US
Mailing Address - Phone:708-807-3872
Mailing Address - Fax:708-460-2626
Practice Address - Street 1:10402 S CICERO AVE
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-4704
Practice Address - Country:US
Practice Address - Phone:708-422-2898
Practice Address - Fax:708-636-8778
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490146611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical