Provider Demographics
NPI:1598834905
Name:LENNON, DANIEL TERRENCE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:TERRENCE
Last Name:LENNON
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 1:2430 PLAINFIELD ROAD
Mailing Address - Street 2:SUITE 2D
Mailing Address - City:CREST HILL
Mailing Address - State:IL
Mailing Address - Zip Code:60403
Mailing Address - Country:US
Mailing Address - Phone:815-439-1336
Mailing Address - Fax:
Practice Address - Street 1:2430 PLAINFIELD ROAD
Practice Address - Street 2:SUITE 2D
Practice Address - City:CREST HILL
Practice Address - State:IL
Practice Address - Zip Code:60403
Practice Address - Country:US
Practice Address - Phone:815-439-1336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker