Provider Demographics
NPI:1578680377
Name:MAJOR, JO STEPHEN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JO
Middle Name:STEPHEN
Last Name:MAJOR
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 W JEFFERSON ST
Mailing Address - Street 2:SUITE 401
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-3960
Mailing Address - Country:US
Mailing Address - Phone:309-828-2960
Mailing Address - Fax:
Practice Address - Street 1:207 W JEFFERSON ST
Practice Address - Street 2:SUITE 401
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-3960
Practice Address - Country:US
Practice Address - Phone:309-828-2960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical