Provider Demographics
NPI:1598706905
Name:FALEY, JODI A (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:A
Last Name:FALEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:JODI
Other - Middle Name:A
Other - Last Name:KRANPITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:12 SALT CREEK LN
Mailing Address - Street 2:SUITE 310
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-8605
Mailing Address - Country:US
Mailing Address - Phone:630-789-7800
Mailing Address - Fax:630-789-7803
Practice Address - Street 1:12 SALT CREEK LN
Practice Address - Street 2:SUITE 310
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-8605
Practice Address - Country:US
Practice Address - Phone:630-789-7800
Practice Address - Fax:630-789-7800
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490115971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical