Provider Demographics
NPI:1598070856
Name:PORTMANN ROBBINS, JOANN (LCSW)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:PORTMANN ROBBINS
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 1:1 E NORTHWEST HWY
Mailing Address - Street 2:SUITE 212
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-1708
Mailing Address - Country:US
Mailing Address - Phone:847-363-0514
Mailing Address - Fax:
Practice Address - Street 1:1 E NORTHWEST HWY
Practice Address - Street 2:SUITE 212
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-1708
Practice Address - Country:US
Practice Address - Phone:847-363-0514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0021131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical